OrganizationBayou Roots Therapy Collective LlcSocial WorkerBehavioral Health & Social Service ProvidersPractice Address117 Heymann Blvd Ste 14, Lafayette, LA 70503-2397(337) 385-0405(337) 278-0786PECOS EnrollmentBased on the most recent information from CMS, provider Bayou Roots Therapy Collective Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1033006184Provider TypeOrganizationFull NameBayou Roots Therapy Collective LlcSubpartNoEnumeration Date6/20/2025Last Updated7/15/2025Contact InformationPractice LocationPractice Address117 Heymann Blvd Ste 14, Lafayette, LA 70503-2397Phone(337) 385-0405Fax(337) 385-0405Mailing LocationMailing AddressPO Box 55, Gulf Shores, AL 36547-0055Phone(337) 278-0786FaxUnlisted FaxAuthorized OfficialNameHerhold, Leslie (Owner)Phone(337) 278-0786Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer