Provider Demographics
NPI:1811997448
Name:LABORDE THERAPY CENTER LLC
Entity type:Organization
Organization Name:LABORDE THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LABORDE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:337-981-4053
Mailing Address - Street 1:2727 KALISTE SALOOM RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7151
Mailing Address - Country:US
Mailing Address - Phone:337-981-4053
Mailing Address - Fax:337-981-2448
Practice Address - Street 1:2727 KALISTE SALOOM RD
Practice Address - Street 2:STE 101
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7151
Practice Address - Country:US
Practice Address - Phone:337-981-4053
Practice Address - Fax:337-981-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 332B00000X, 225X00000X
LA1538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF7451OtherBLUE CROSS GROUP ID
LA5C824Medicare ID - Type UnspecifiedMEDICARE GROUP #
LAF7451OtherBLUE CROSS GROUP ID