Provider Demographics
NPI:1942070792
Name:LAFAYETTE INTENSIVE OUTPATIENT, LLC
Entity Type:Organization
Organization Name:LAFAYETTE INTENSIVE OUTPATIENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-857-5937
Mailing Address - Street 1:PO BOX 81098
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70598-1098
Mailing Address - Country:US
Mailing Address - Phone:337-857-5937
Mailing Address - Fax:
Practice Address - Street 1:219 E VEROT SCHOOL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3311
Practice Address - Country:US
Practice Address - Phone:337-857-5937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty