Healthcare Provider Details

I. General information

NPI: 1215247283
Provider Name (Legal Business Name): LTAC HOSPITAL OF LOUISIANA - DENHAM SPRINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8375 FLORIDA BLVD
DENHAM SPRINGS LA
70726-7806
US

IV. Provider business mailing address

101 LA RUE FRANCE SUITE 500
LAFAYETTE LA
70508-3144
US

V. Phone/Fax

Practice location:
  • Phone: 225-665-2664
  • Fax: 225-665-0736
Mailing address:
  • Phone: 337-269-9566
  • Fax: 337-269-9823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. JESSICA MCGEE
Title or Position: CFO
Credential:
Phone: 337-269-9566