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General NPI Number Information
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NPI Number | 1629039193
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Entity Type | Organization
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Legal Business Name | RIVERSIDE HOSPITAL OF LOUISIANA, INC.
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 13 HEYMAN LN
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3574
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Country | US
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Telephone | 318-767-2900
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Fax | 318-442-4505
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Provider Business Mailing Address
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Address Line | 1000 CHINABERRY DR STE 200
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City | BOSSIER CITY
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State | LA
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Zip | 71111-2443
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Country | US
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Telephone | 318-684-6050
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Fax | 318-684-6051
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Authorized Official
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Title or Position | GROUP PRESIDENT
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Name | MR. WADE LESTER
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Credential |
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Telephone | 318-684-6050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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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 | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number |
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License Number State |
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