Provider Demographics
NPI:1427592831
Name:BATON ROUGE REHABILITATION HOSPITAL
Entity type:Organization
Organization Name:BATON ROUGE REHABILITATION HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE/PAYOR RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA
Authorized Official - Phone:225-505-7399
Mailing Address - Street 1:8595 UNITED PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2251
Mailing Address - Country:US
Mailing Address - Phone:225-231-3118
Mailing Address - Fax:225-928-0317
Practice Address - Street 1:8595 UNITED PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2251
Practice Address - Country:US
Practice Address - Phone:225-231-3118
Practice Address - Fax:225-928-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA679283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1747670Medicaid
LA1747670Medicaid