Organization
LAFAYETTE COMMUNITY REHABILITATION HOSPITAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE DYSON NICHOLS (ADMINISTRATOR)
(337) 234-4031
Entity
Organization
Contact information
Practice address
408 SE EVANGELINE THRUWAY, LAFAYETTE, LA 70501
(337) 234-4031
(337) 210-1558
Mailing address
408 SE EVANGELINE THRUWAY, LAFAYETTE, LA 70501
(337) 234-4031
(337) 210-1558
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
592
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1763519
—
LA
01
—
61229
BLUE CROSS OF LA
LA
Enumeration date
04/05/2006
Last updated
12/29/2009
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