| Organization Name: | IBERVILLE CARDIAC REHAB INC |
| NPI Number: | 1306167275 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA GIZZELA HENRY (OWNER) |
| Mailing Address: | 59350 River West Dr Suite 104 Plaquemine |
| State: | LA US |
| Postal Code: | 707646553 |
| Phone Number: | 5048122455 |
| Fax Number: | |
| NPI Enumeration Date: | 06/15/2010 |
| NPI Last Update Date: | 06/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0404X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Cardiac Facilities |
| Taxonomy Definition: | |