Healthcare Provider Details

I. General information

NPI: 1619130283
Provider Name (Legal Business Name): LAMAR HEALTHCARE & REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6428 U S HIGHWAY 11
LUMBERTON MS
39455-7524
US

IV. Provider business mailing address

215 W BANDERA RD SUITE 114 - PMB 616
BOERNE TX
78006-2820
US

V. Phone/Fax

Practice location:
  • Phone: 601-794-8566
  • Fax:
Mailing address:
  • Phone: 713-385-0863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DAVID O. CROWSON
Title or Position: PRESIDENT
Credential:
Phone: 713-385-0863