Healthcare Provider Details

I. General information

NPI: 1962841197
Provider Name (Legal Business Name): POST ACUTE SPECIALTY HOSPITAL OF LAFAYETTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 ENERGY PKWY
LAFAYETTE LA
70508-3816
US

IV. Provider business mailing address

1828 GOOD HOPE RD SUITE 102
ENOLA PA
17025-1233
US

V. Phone/Fax

Practice location:
  • Phone: 804-204-1537
  • Fax: 804-254-1972
Mailing address:
  • Phone: 717-731-9660
  • Fax: 717-731-9665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number StateLA

VIII. Authorized Official

Name: MR. ANTHONY MISITANO
Title or Position: PRESIDENT
Credential:
Phone: 717-731-9660