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Organization
RIVERSIDE REHABILITATION AGENCY, INC.
Active
Organization
RIVERSIDE REHABILITATION AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA ANN BANKS (OWNER)
(225) 936-2021
Entity
Organization
Contact information
Practice address
8680 BLUEBONNET BLVD, SUITE D, BATON ROUGE, LA 70810-7825
(225) 936-2021
Mailing address
6835 S FIELDGATE CT, BATON ROUGE, LA 70808-5452
(225) 936-2021
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1566250
—
LA
Enumeration date
06/04/2006
Last updated
10/19/2011
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