# SOUTHERN OAKS NURSING & REHABILITATION CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTHERN OAKS NURSING & REHABILITATION CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124186937
- **Authorized official:** TEDDY RAY PRICE (MANAGING MEMBER)
- **Authorized official phone:** (318) 628-4116

## Contact information

- **Practice address:** 1524 GLEN OAK PL, SHREVEPORT, LA 71103-3816
- **Practice address phone:** (318) 221-0911
- **Practice address fax:** (318) 222-6333
- **Mailing address:** 1524 GLEN OAK PL, SHREVEPORT, LA 71103-3816
- **Mailing address phone:** (318) 221-0911
- **Mailing address fax:** (318) 222-6333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 93 | LA | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 09/10/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1510394 | — | LA |