Provider Demographics
NPI:1508056813
Name:LAFOURCHE PARISH SCHOOL BOARD
Entity Type:Organization
Organization Name:LAFOURCHE PARISH SCHOOL BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:985-446-5631
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-0879
Mailing Address - Country:US
Mailing Address - Phone:985-446-5631
Mailing Address - Fax:985-446-0801
Practice Address - Street 1:805 E 7TH ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3606
Practice Address - Country:US
Practice Address - Phone:985-446-5631
Practice Address - Fax:985-446-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1701351Medicaid