Provider Demographics
NPI:1699499269
Name:SAGE REHAB HOSPITAL OF LAFAYETTE OPERATIONS, LLC
Entity type:Organization
Organization Name:SAGE REHAB HOSPITAL OF LAFAYETTE OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-368-3181
Mailing Address - Street 1:204 ENERGY PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3816
Mailing Address - Country:US
Mailing Address - Phone:337-446-4300
Mailing Address - Fax:866-815-7594
Practice Address - Street 1:204 ENERGY PKWY STE E
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3816
Practice Address - Country:US
Practice Address - Phone:337-446-4300
Practice Address - Fax:866-815-7594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit