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Organization
REHABILITATION SERVICES OF SOUTHWEST LOUISIANA, LLC
Active
Organization
REHABILITATION SERVICES OF SOUTHWEST LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE JACOB (COO)
(318) 746-0420
Entity
Organization
Contact information
Practice address
751 BAYOU PINES EAST DR STE C, LAKE CHARLES, LA 70601-7196
(337) 433-3292
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 746-0420
(318) 626-5429
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/11/2009
Last updated
07/24/2023
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