MEDICARE: KPC PROMISE HOSPITAL OF BATON ROUGE 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	282E00000X	Long Term Care Hospital

General Provider Information

NPI Number	:	1851955298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KPC PROMISE HOSPITAL OF BATON ROUGE LLC

Provider Business Mailing Address
First Line	:	900 N FEDERAL HWY STE 350
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-2754
Country	:	US
Telephone Number	:	561-869-6505
Fax Number	:

Provider Business Practice Location Address
First Line	:	5130 MANCUSO LN
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3583
Country	:	US
Telephone Number	:	225-490-9600
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	WILLIAM THOMAS
Credential	:
Telephone Number	:	951-987-8100

Provider Enumeration Date	:	04/30/2019
Last Update Date	:	11/01/2021

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