Organization
SAGE REHABILITATION HOSPITAL COVINGTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK MITCHELL (MEMBER)
(225) 368-3181
Entity
Organization
Contact information
Practice address
5025 KEYSTONE BLVD STE 200, COVINGTON, LA 70433-7517
(985) 888-0301
Mailing address
10615 JEFFERSON HWY, BATON ROUGE, LA 70809-7230
(225) 368-3181
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193097
MEDICARE - PENDING
—
Enumeration date
11/20/2017
Last updated
11/20/2017
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