Healthcare Provider Details

I. General information

NPI: 1164708335
Provider Name (Legal Business Name): ROSEVIEW NURSING AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 MANSFIELD RD
SHREVEPORT LA
71103-4107
US

IV. Provider business mailing address

3405 MANSFIELD RD
SHREVEPORT LA
71103-4107
US

V. Phone/Fax

Practice location:
  • Phone: 318-222-3100
  • Fax: 318-222-3930
Mailing address:
  • Phone: 318-222-3100
  • Fax: 318-222-3930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number835
License Number StateLA

VIII. Authorized Official

Name: TEDDY R PRICE
Title or Position: MANAGING MEMBER
Credential:
Phone: 318-628-4116