Healthcare Provider Details

I. General information

NPI: 1841783818
Provider Name (Legal Business Name): ALEXANDRIA REHABILITATION , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N 3RD ST
ALEXANDRIA LA
71301
US

IV. Provider business mailing address

1813 NORTHPOINTE LN
RUSTON LA
71270-3879
US

V. Phone/Fax

Practice location:
  • Phone: 318-449-1370
  • Fax: 318-449-8495
Mailing address:
  • Phone: 318-255-7591
  • Fax: 318-255-7584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateLA

VIII. Authorized Official

Name: DR. HARRY J. LENABURG
Title or Position: OWNER
Credential: M.D.
Phone: 318-449-1370