Provider Demographics
NPI:1992993109
Name:DALLAS SOUTHEAST LONG TERM ACUTE CARE, LLC
Entity type:Organization
Organization Name:DALLAS SOUTHEAST LONG TERM ACUTE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXEC VP
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REINAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-388-8814
Mailing Address - Street 1:7525 SCYENE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-5687
Mailing Address - Country:US
Mailing Address - Phone:214-388-8814
Mailing Address - Fax:
Practice Address - Street 1:1824 1ST DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5756
Practice Address - Country:US
Practice Address - Phone:843-278-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital