Provider Demographics
NPI:1851523898
Name:BAYOU HEALTH 2001, INC.
Entity Type:Organization
Organization Name:BAYOU HEALTH 2001, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-446-2075
Mailing Address - Street 1:1201 BRASHEAR AVE
Mailing Address - Street 2:SUITE 431
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1361
Mailing Address - Country:US
Mailing Address - Phone:985-384-8621
Mailing Address - Fax:985-384-8622
Practice Address - Street 1:1201 BRASHEAR AVE
Practice Address - Street 2:SUITE 431
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1361
Practice Address - Country:US
Practice Address - Phone:985-384-8621
Practice Address - Fax:985-384-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-09
Last Update Date:2009-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA20150311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility