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General NPI Number Information
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NPI Number | 1720434137
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Entity Type | Organization
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Legal Business Name | D N L OUTPATIENT REHAB, LLC
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 671 HWY 171 SUITE C
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City | STONEWALL
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State | LA
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Zip | 71078-3312
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Country | US
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Telephone | 318-775-4124
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Fax |
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Provider Business Mailing Address
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Address Line | 3852 HIGHWAY 171 APT 401
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City | GLOSTER
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State | LA
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Zip | 71030-3344
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FELICIA HALL
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Credential |
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Telephone | 318-461-3041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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