Healthcare Provider Details

I. General information

NPI: 1134754302
Provider Name (Legal Business Name): NEW LIFECARE SPECIALTY HOSPITAL OF NORTH LOUISIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401B EZELLE ST
RUSTON LA
71270-7218
US

IV. Provider business mailing address

1000 CHINABERRY DR STE 200
BOSSIER CITY LA
71111-2443
US

V. Phone/Fax

Practice location:
  • Phone: 318-251-3126
  • Fax:
Mailing address:
  • Phone: 318-658-9977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER KEMP WRIGHT
Title or Position: BOARD MEMBER
Credential:
Phone: 318-658-9977