Organization
CLC OF LAKE PROVIDENCE, LLC
Active
Other names
Lake Providence Subacute Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS M. WRIGHT JR. (MANAGING MEMBER)
(662) 680-3148
Entity
Organization
Contact information
Practice address
5976 HIGHWAY 65 N, LAKE PROVIDENCE, LA 71254-5235
(318) 559-4050
(318) 559-4052
Mailing address
5976 HIGHWAY 65 N, LAKE PROVIDENCE, LA 71254-5235
(318) 559-4050
(318) 559-4052
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
750
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520632
—
LA
Enumeration date
10/25/2005
Last updated
01/28/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us