Organization
SOUTHEAST REHAB LLC
Active
Other names
Southeast Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE MARTIN WALDROP MED, LPC, NBCC (ADMINISTRATOR/CEO)
(318) 665-9950
Entity
Organization
Contact information
Practice address
905 BORGOGNONI DR, LAKE VILLAGE, AR 71653-1623
(318) 665-9950
(318) 665-0379
Mailing address
905 BORGOGNONI DR, LAKE VILLAGE, AR 71653-1623
(318) 665-9950
(318) 665-0379
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
AR4376
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163180526
—
AR
Enumeration date
11/16/2006
Last updated
11/07/2025
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