# IN HOME REHAB OF LOUISIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962049064
- **Authorized official:** MS. SHARRON BUSH SMITH LOTR (OWNER)
- **Authorized official phone:** (337) 541-0201

## Contact information

- **Practice address:** 102 RAPHAEL DR, LAFAYETTE, LA 70508-5952
- **Practice address phone:** (337) 849-7431
- **Mailing address:** 102 RAPHAEL DR, LAFAYETTE, LA 70508-5952
- **Mailing address phone:** (337) 849-7431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 12/08/2019
- **Last updated:** 12/08/2019