Provider Demographics
NPI:1699749531
Name:BATON ROUGE REHABILITATION HOSPITAL LLC
Entity type:Organization
Organization Name:BATON ROUGE REHABILITATION HOSPITAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:VIATOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-237-1540
Mailing Address - Street 1:8490 PICARDY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-237-1505
Mailing Address - Fax:225-237-1623
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
Practice Address - Country:US
Practice Address - Phone:225-927-0567
Practice Address - Fax:225-928-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-16
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA312283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
60950OtherBLUE CROSS
LA1747670Medicaid
LA193028Medicare UPIN