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General NPI Number Information
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NPI Number | 1417349929
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Entity Type | Organization
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Legal Business Name | NORTHEAST LOUISIANA REHABILITATION
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Dates
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Enumeration Date | 02/21/2015
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 204 BOOTS DR
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City | FARMERVILLE
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State | LA
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Zip | 71241-3102
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Country | US
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Telephone | 318-620-0075
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Fax | 318-620-0070
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Provider Business Mailing Address
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Address Line | 246 ALONZO RD
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City | WEST MONROE
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State | LA
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Zip | 71291-1731
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Country | US
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Telephone | 318-620-0075
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Fax |
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Authorized Official
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Title or Position | PHYSICAL AND OCCUPATIONAL THERAPIST
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Name | CASEY SCARBOROUGH ECKHARDT
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Credential | MOT, LOTR, PT, DPT
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Telephone | 318-620-0075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT 08698
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OTT.200620
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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