Lake Providence Subacute Rehab Center

LBN: Clc Of Lake Providence, Llc
Lake Providence Subacute Rehab Center is an health care organization with primary practice located at 5976 Highway 65 N , Lake Providence LA 71254-5235. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Clc Of Lake Providence, Llc can be contacted via phone (318) 559-4050, or through Wright, Douglas M. via phone (662) 680-3148.

Contact Information

Primary practice address
5976 Highway 65 N Lake Providence LA 71254-5235
Phone: (318) 559-4050
Fax: (318) 559-4052
Website:
Map and Directions
Authorized official contact:
Name: Wright, Douglas M.
Phone: (662) 680-3148

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 750 Louisiana

Profile Details

NPI number 1902896657
LBN Legal business name Clc Of Lake Providence, Llc
DBA Doing business as Lake Providence Subacute Rehab Center
Authorized official Wright, Douglas M.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2005
Last updated Jan 28th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902896657 NPPES
Louisiana MEDICAID 1520632

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