Provider Demographics
NPI:1609833292
Name:TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1
Entity Type:Organization
Organization Name:TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1
Other - Org Name:TERREBONNE GENERAL HOSPITAL SKILLED NURSING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:D
Authorized Official - Last Name:YEATES
Authorized Official - Suffix:
Authorized Official - Credentials:CPA MBA
Authorized Official - Phone:985-873-4664
Mailing Address - Street 1:PO BOX 6037
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-6037
Mailing Address - Country:US
Mailing Address - Phone:985-873-4235
Mailing Address - Fax:985-851-4307
Practice Address - Street 1:8166 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-873-4141
Practice Address - Fax:985-851-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA159314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA474543OtherAETNA
LA13064OtherBLUE CROSS PROFESSIONAL
LA1720275Medicaid
LA5000076OtherUNITED HEALTHCARE
LA33638OtherBLUE CROSS BLUE SHIELD
LA1720275Medicaid
LA5000076OtherUNITED HEALTHCARE