# DESOTO RETIREMENT & REHAB CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** DeSoto Retirement & Rehab Center, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396728739
- **Authorized official:** MR. JACK SANDERS (MANAGING MEMBER)
- **Authorized official phone:** (318) 590-0007

## Contact information

- **Practice address:** 635 SCHLEY ST, MANSFIELD, LA 71052-3820
- **Practice address phone:** (318) 872-0276
- **Practice address fax:** (318) 872-5867
- **Mailing address:** 635 SCHLEY ST, MANSFIELD, LA 71052-3820
- **Mailing address phone:** (318) 872-0276
- **Mailing address fax:** (318) 872-5867

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 805 | LA | Yes |

## Other

- **Enumeration date:** 11/21/2005
- **Last updated:** 01/11/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1518212 | — | LA |