Healthcare Provider Details

I. General information

NPI: 1548574536
Provider Name (Legal Business Name): LOUISIANA HEALTH AND REHAB CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 WOODDALE BLVD
BATON ROUGE LA
70806-1442
US

IV. Provider business mailing address

214 OCEAN DR
BATON ROUGE LA
70806-4618
US

V. Phone/Fax

Practice location:
  • Phone: 225-927-0770
  • Fax: 225-927-0771
Mailing address:
  • Phone: 225-231-2490
  • Fax: 225-231-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberCM27013
License Number StateLA

VIII. Authorized Official

Name: SOUNDRA TEMPLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 225-231-2490