MEDICARE: LAFAYETTE REGIONAL 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
1	283X00000X	Rehabilitation Hospital		IN

General Provider Information

NPI Number	:	1568713410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAFAYETTE REGIONAL REHABILITATION HOSPITAL LLC

Provider Business Mailing Address
First Line	:	1024 N GALLOWAY AVE STE 102
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75149-2434
Country	:	US
Telephone Number	:	972-216-2299
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 PARK EAST BLVD
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-0792
Country	:	US
Telephone Number	:	765-447-4040
Fax Number	:	765-447-4042

Authorized Official
Title or Position	:	VICE PRESIDENT AND SECRETARY
Name	:	DENISE KANN
Credential	:
Telephone Number	:	972-216-2299

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	11/14/2025

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