Organization
SHREVEPORT REHABILITATION HOSPITAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY NIXON (CHIEF COMPLIANCE OFFICER)
(469) 640-6503
Entity
Organization
Contact information
Practice address
1451 FERN CIRCLE, SHREVEPORT, LA 71105-7501
(469) 640-6503
Mailing address
450 CENTURY PKWY STE 220, ALLEN, TX 75013-8135
(469) 640-6503
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
11/25/2024
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