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General NPI Number Information
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NPI Number | 1609077304
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Entity Type | Organization
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Legal Business Name | SOUTHERN REGIONAL HEALTHCARE SYSTEMS, INC.
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1501 HOSPITAL AVE
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City | FRANKLIN
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State | LA
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Zip | 70538-3724
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Country | US
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Telephone | 337-519-2851
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Fax | 337-276-6671
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Provider Business Mailing Address
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Address Line | 2208 HIGHWAY 318
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City | JEANERETTE
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State | LA
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Zip | 70544-8506
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Country | US
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Telephone | 337-276-6697
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Fax | 337-276-6671
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. CRAIG ALONZO MATHEWS
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Credential | BACHELOR OF SCIENCE
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Telephone | 337-276-6697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | APPLIED FOR
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License Number State | LA
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