# 4005 BR SNF, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mid City Community Nursing and Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942810221
- **Authorized official:** MR. PATRICK MITCHELL (MANAGER)
- **Authorized official phone:** (225) 368-3181

## Contact information

- **Practice address:** 4005 NORTH BLVD, BATON ROUGE, LA 70806-3830
- **Practice address phone:** (225) 923-7280
- **Practice address fax:** (225) 387-5939
- **Mailing address:** 10615 JEFFERSON HWY, BATON ROUGE, LA 70809-7230
- **Mailing address phone:** (225) 368-3181

## Taxonomy

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

## Other

- **Enumeration date:** 08/03/2020
- **Last updated:** 10/05/2020