Organization
REHABILITATION SERVICES OF SOUTHWEST LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE JACOB (COO)
(318) 746-0420
Entity
Organization
Contact information
Practice address
751 BAYOU PINES EAST DR STE C, LAKE CHARLES, LA 70601-7196
(337) 433-3292
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 746-0420
(318) 626-5429
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/11/2009
Last updated
07/24/2023
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