Organization
BAYOU RAPIDES REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JODIE LINCOLN ROBERTS II M.S. (DIRECTOR)
(318) 561-2010
Entity
Organization
Contact information
Practice address
3620 BAYOU RAPIDES RD, ALEXANDRIA, LA 71303-3653
(318) 561-2010
(318) 561-0098
Mailing address
PO BOX 12368, ALEXANDRIA, LA 71315-2368
(318) 561-2010
(318) 561-0098
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1434507
—
LA
Enumeration date
08/19/2006
Last updated
08/22/2020
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