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Organization
SOUTHEAST REHAB LLC
Active
Organization
SOUTHEAST REHAB LLC
Active
Parent organization
SOUTHEAST REHAB LLC
Other names
Southeast Rural Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST REHAB LLC
Authorized official
CATHERINE MARTIN WALDROP (ADMINISTRATOR)
(318) 665-9950
Entity
Organization
Contact information
Practice address
608 S HIGHWAY 65 82, LAKE VILLAGE, AR 71653-1743
(870) 265-4333
(318) 665-9950
Mailing address
PO BOX 743, LAKE VILLAGE, AR 71653-0743
(318) 665-9950
(318) 665-0379
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
283X00000X
Rehabilitation Hospital
—
NULL
Other
Enumeration date
02/13/2020
Last updated
03/24/2023
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