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NPI Code Detail

MEDICARE: PELICAN REHABILITATION HOSPITAL, LLC

MEDICARE: PELICAN REHABILITATION HOSPITAL, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283X00000XRehabilitation Hospital

General Provider Information

NPI Number : 1053754606
Entity Type Code : Organization
Provider Name (Legal Business Name) : PELICAN REHABILITATION HOSPITAL, LLC
Provider Business Mailing Address
First Line : 41191 CITADEL DR
Second Line :
City : SORRENTO
State : LA
Zip : 70778-3425
Country : US
Telephone Number : 225-341-9351
Fax Number : 225-644-8341
Provider Business Practice Location Address
First Line : 4201 WOODLAND DR
Second Line : 3RD FLOOR
City : NEW ORLEANS
State : LA
Zip : 70131-7339
Country : US
Telephone Number : 504-378-5060
Fax Number : 504-378-5061
Authorized Official
Title or Position : PRESIDENT
Name : MRS. SYBIL C MILES
Credential :
Telephone Number : 225-341-9351
Provider Enumeration Date : 04/14/2013
Last Update Date : 09/19/2013

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