Organization
SPECIALTY REHABILITATION HOSPITAL, L.L.C.
Active
Other names
Specialty Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP CRAIG BALL (GOVERNING BOARD CHAIRMAN / CEO)
(337) 238-4449
Entity
Organization
Contact information
Practice address
1110 RINGGOLD AVENUE, SUITE B, COUSHATTA, LA 71019
(318) 932-1770
(318) 932-1772
Mailing address
P.O. BOX 309, COUSHATTA, LA 71019
(318) 932-1770
(318) 932-1772
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
630
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1702021
—
LA
01
—
193080
MEDICARE PROVIDER NUMBER
—
Enumeration date
09/26/2007
Last updated
07/03/2008
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