MEDICARE: BETHESDA REHABILITATION HOSPITAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283X00000X	Rehabilitation Hospital	675	LA
2	283X00000X	Rehabilitation Hospital	193092	LA
3	283X00000X	Rehabilitation Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558388470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETHESDA REHABILITATION HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	501 RUE DE SANTE, SUITE 12
Second Line	:
City	:	LAPLACE
State	:	LA
Zip	:	70068
Country	:	US
Telephone Number	:	985-653-0950
Fax Number	:	985-653-0190

Provider Business Practice Location Address
First Line	:	7414 SUMRALL DRIVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812
Country	:	US
Telephone Number	:	225-767-2034
Fax Number	:	225-767-2039

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LIONEL MURPHY JR.
Credential	:
Telephone Number	:	985-653-0950

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	12/03/2018

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