Provider Demographics
NPI:1942029129
Name:OPTI-HEALTH LLC
Entity type:Organization
Organization Name:OPTI-HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:THERIOT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:337-344-4977
Mailing Address - Street 1:11150 HARRIS LN
Mailing Address - Street 2:
Mailing Address - City:MAURICE
Mailing Address - State:LA
Mailing Address - Zip Code:70555-3629
Mailing Address - Country:US
Mailing Address - Phone:337-344-4977
Mailing Address - Fax:
Practice Address - Street 1:213 E ETIENNE RD
Practice Address - Street 2:
Practice Address - City:MAURICE
Practice Address - State:LA
Practice Address - Zip Code:70555-4375
Practice Address - Country:US
Practice Address - Phone:337-740-9663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty