Healthcare Provider Details

I. General information

NPI: 1992124697
Provider Name (Legal Business Name): REHABILITATION HOSPITAL OF LEESVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S 6TH ST
LEESVILLE LA
71446-4723
US

IV. Provider business mailing address

5600 WYOMING BLVD NE STE 225
ALBUQUERQUE NM
87109-3136
US

V. Phone/Fax

Practice location:
  • Phone: 337-392-8118
  • Fax: 337-392-8415
Mailing address:
  • Phone: 505-317-3802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: KRISTI DUNCAN
Title or Position: CFO
Credential:
Phone: 505-317-3802