Healthcare Provider Details
I. General information
NPI: 1982194817
Provider Name (Legal Business Name): ACCORD REHABILITATION PART B PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2018
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
59213 RIVERWEST DR.
PLAQUEMINE LA
70764
US
IV. Provider business mailing address
59213 RIVERWEST DR.
PLAQUEMINE LA
70764
US
V. Phone/Fax
- Phone: 225-687-8100
- Fax:
- Phone: 225-687-8100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULENE
MCALISTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 225-687-8100