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Organization

PROMISE HOSPITAL OF LOUISIANA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES HOPWOOD (CFO)
(561) 869-3100
Entity
Organization

Contact information

Practice address
1800 IRVING PL, SHREVEPORT, LA 71101-4608
(318) 425-4096
(318) 425-8483
Mailing address
999 YAMATO ROAD, 3RD FLOOR, BOCA RATON, FL 33431
(561) 869-3100
(561) 826-0171

Taxonomy

Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
516
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760935
LA
01
60067
BLUE CROSS PSYCH PROV. #
LA
01
60068
BLUE CROSS REHAB PROV. #
LA
01
61093
BLUE CROSS PROVIDER NUMBE
LA
Enumeration date
03/14/2006
Last updated
04/10/2018
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