Organization Name: | NORTHEAST LOUISIANA REHABILITATION |
NPI Number: | 1417349929 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CASEY NICOLE SCARBOROUGH (PHYSICAL AND OCCUPATIONAL THERAPIST) |
Mailing Address: | 59 Covington Rd Rayville |
State: | LA US |
Postal Code: | 712694276 |
Phone Number: | 3183819337 |
Fax Number: | |
NPI Enumeration Date: | 02/21/2015 |
NPI Last Update Date: | 02/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | OTT.200620 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |