Healthcare Provider Details

I. General information

NPI: 1558388470
Provider Name (Legal Business Name): BETHESDA REHABILITATION HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7414 SUMRALL DRIVE
BATON ROUGE LA
70812
US

IV. Provider business mailing address

501 RUE DE SANTE, SUITE 12
LAPLACE LA
70068
US

V. Phone/Fax

Practice location:
  • Phone: 225-767-2034
  • Fax: 225-767-2039
Mailing address:
  • Phone: 985-653-0950
  • Fax: 985-653-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number675
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number193092
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. LIONEL MURPHY JR.
Title or Position: PRESIDENT
Credential:
Phone: 985-653-0950