Magnolia Comprehensive Outpatient Rehabiliation Facility Inc.
LBN: Magnolia Comprehensive Outpatient Rehabiliation Facility Inc.
Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. is an health care organization with primary practice located at 2005 Creswell Ave , Shreveport LA 71104-2201. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF), which is considered as the primary health care specialty.
Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. can be contacted via phone (318) 676-0705, or through Brantley, Dewarrent Lee via phone (318) 676-0705.
Contact Information
Primary practice address
2005 Creswell Ave
Shreveport LA 71104-2201
Phone: (318) 676-0705
Fax: (318) 676-0709
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X |
Profile Details
| NPI number | 1407853716 |
|---|---|
| LBN Legal business name | Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. |
| DBA Doing business as | |
| Authorized official | Brantley, Dewarrent Lee |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Aug 18th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407853716 | NPPES |
| Louisiana | MEDICAID | 1159310 |
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