Provider Demographics
NPI:1942508510
Name:HEALTHY YOU SOCIAL SERVICES, LLC
Entity Type:Organization
Organization Name:HEALTHY YOU SOCIAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TIBBERLY
Authorized Official - Middle Name:G
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:337-942-6400
Mailing Address - Street 1:209 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6256
Mailing Address - Country:US
Mailing Address - Phone:337-942-6400
Mailing Address - Fax:337-948-7400
Practice Address - Street 1:209 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6256
Practice Address - Country:US
Practice Address - Phone:337-942-6400
Practice Address - Fax:337-948-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1811137011Medicaid