Provider Demographics
| NPI: | 1447017355 |
|---|---|
| Name: | ANCHORED HEALTH LLC |
| Entity type: | Organization |
| Organization Name: | ANCHORED HEALTH LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JOSEPH |
| Authorized Official - Middle Name: | KENNETH |
| Authorized Official - Last Name: | THIBEAUX |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 225-810-6134 |
| Mailing Address - Street 1: | 201 SWEET RIDGE WAY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | YOUNGSVILLE |
| Mailing Address - State: | LA |
| Mailing Address - Zip Code: | 70592-4504 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 225-810-6134 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 201 SWEET RIDGE WAY |
| Practice Address - Street 2: | |
| Practice Address - City: | YOUNGSVILLE |
| Practice Address - State: | LA |
| Practice Address - Zip Code: | 70592-4504 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 225-810-6134 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-03-06 |
| Last Update Date: | 2024-03-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
| No | 261QF0050X | Ambulatory Health Care Facilities | Clinic/Center | Family Planning, Non-Surgical |
| No | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
| No | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center | Methadone |
| No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
