Healthcare Provider Details

I. General information

NPI: 1538278718
Provider Name (Legal Business Name): ST. ANNE REHABILITATION HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 DUNN ST
HOUMA LA
70360-4707
US

IV. Provider business mailing address

629 DUNN ST
HOUMA LA
70360-4707
US

V. Phone/Fax

Practice location:
  • Phone: 985-274-0001
  • Fax: 985-274-0003
Mailing address:
  • Phone: 985-274-0001
  • Fax: 985-274-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number473
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number473
License Number StateLA

VIII. Authorized Official

Name: MR. EUGENE E. SMITH
Title or Position: PRESIDENT & COO
Credential:
Phone: 225-216-2299