Organization
DERIDDER RETIREMENT & REHABILITATION CENTER, LLC
Active
Other names
DeRidder Retirement & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK SANDERS (MANAGING MEMBER)
(318) 590-0007
Entity
Organization
Contact information
Practice address
1420 BLANKENSHIP DR, DERIDDER, LA 70634-4604
(337) 463-9022
(337) 462-0719
Mailing address
1420 BLANKENSHIP DR, DERIDDER, LA 70634-4604
(337) 463-9022
(337) 462-0719
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
885
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510882
—
LA
Enumeration date
11/30/2005
Last updated
08/23/2007
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