| Thibodaux Behavioral Health, Llc. | |
|
209 New Hope Dr Thibodaux LA 70301-8087 | |
| (985) 387-1198 | |
| Not Available |
| Full Name | Thibodaux Behavioral Health, Llc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 209 New Hope Dr, Thibodaux, Louisiana |
| Authorized Official Name and Position | Venkata Devabhaktuni (OWNER/MD) |
| Authorized Official Contact | 9853871198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thibodaux Behavioral Health, Llc. 209 New Hope Dr Thibodaux LA 70301-8087 Ph: (985) 852-2317 | Thibodaux Behavioral Health, Llc. 209 New Hope Dr Thibodaux LA 70301-8087 Ph: (985) 387-1198 |
| NPI Number | 1124732540 |
|---|---|
| Provider Enumeration Date | 01/10/2023 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Medicare PECOS PAC ID | 2062887938 |
|---|---|
| Medicare Enrollment ID | O20230406000112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124732540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Venkata S Devabhaktuni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891734752 PECOS PAC ID: 0941261374 Enrollment ID: I20191010001345 |
Dr. Maria B. Cruse Apmg Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 North Acadia Road, Suite 201, Thibodaux, LA 70301 Phone: 985-493-9304 Fax: 985-493-9305 | |
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