Organization
PREMIER REHAB OF SOUTHWEST LOUISIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ANTHONY BROWN (PRESIDENT AND CEO)
(318) 542-9367
Entity
Organization
Contact information
Practice address
840 W BAYOU PINES DR STE B, LAKE CHARLES, LA 70601-7495
(318) 542-9367
Mailing address
PO BOX 13958, ALEXANDRIA, LA 71315-3958
(318) 542-9367
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/20/2013
Last updated
04/20/2013
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