Healthcare Provider Details

I. General information

NPI: 1699777961
Provider Name (Legal Business Name): CRANE REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RIVER RD STE 112
JEFFERSON LA
70121-4226
US

IV. Provider business mailing address

101 RIVER RD STE 112
JEFFERSON LA
70121-4226
US

V. Phone/Fax

Practice location:
  • Phone: 504-828-7696
  • Fax: 504-828-8935
Mailing address:
  • Phone: 504-828-7696
  • Fax: 504-828-8935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberL#Z10453
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number01635
License Number StateLA

VIII. Authorized Official

Name: MRS. SHARON A CRANE
Title or Position: COOWNER
Credential: LOTR
Phone: 504-828-7696