=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902286651
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HHL THERAPY CENTERS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2015
-----------------------------------------------------
Last Update Date | 06/08/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7015 HIGHWAY 190 EAST SERVICE RD SUITE 103
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433-4960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-892-5716
-----------------------------------------------------
Fax | 985-892-5707
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7015 HIGHWAY 190 EAST SERVICE RD SUITE 103
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433-4960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-892-5716
-----------------------------------------------------
Fax | 985-892-5707
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGER
-----------------------------------------------------
Name | NADIA L JOHNSON
-----------------------------------------------------
Credential | MOT, LOTR
-----------------------------------------------------
Telephone | 985-892-5716
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OTT200182
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------