Organization
ST LUKES REHABILITATION HOSPITAL OF SHREVEPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK COMEAUX (CFO)
(337) 237-4191
Entity
Organization
Contact information
Practice address
2140 MIDWAY ST, SHREVEPORT, LA 71108-2206
(337) 237-4191
Mailing address
2140 MIDWAY ST, SHREVEPORT, LA 71108-2206
(337) 237-4191
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1701971
—
LA
Enumeration date
04/18/2007
Last updated
08/22/2020
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