1992855035 NPI number — RHODES REHABILITATION LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992855035 NPI number — RHODES REHABILITATION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RHODES REHABILITATION LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992855035
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1605 HARVEST DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUMA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-872-3285
Provider Business Mailing Address Fax Number:
985-872-3205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 SCHOOL STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUMA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-872-3285
Provider Business Practice Location Address Fax Number:
985-872-3205
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RHODES
Authorized Official First Name:
HEIDI
Authorized Official Middle Name:
SPEARMAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
985-872-3285

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1475998 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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