Healthcare Provider Details

I. General information

NPI: 1609801208
Provider Name (Legal Business Name): JOHN J. HAINKEL, JR. HOME & REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 HENRY CLAY AVE
NEW ORLEANS LA
70118-5818
US

IV. Provider business mailing address

612 HENRY CLAY AVE
NEW ORLEANS LA
70118-5818
US

V. Phone/Fax

Practice location:
  • Phone: 504-896-1321
  • Fax: 504-896-1329
Mailing address:
  • Phone: 504-896-1321
  • Fax: 504-896-1329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number32
License Number StateLA

VIII. Authorized Official

Name: MR. ROBERT E. BALES SR.
Title or Position: LTC HOSPITAL ADMINISTRATOR
Credential: NFA, MPA
Phone: 504-896-1321