Provider Demographics
NPI:1033378187
Name:TOURO REHAB CENTER
Entity Type:Organization
Organization Name:TOURO REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER VP
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:FICKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-897-8568
Mailing Address - Street 1:1401 FOUCHER ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3515
Mailing Address - Country:US
Mailing Address - Phone:504-897-8568
Mailing Address - Fax:504-897-7008
Practice Address - Street 1:1401 FOUCHER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3515
Practice Address - Country:US
Practice Address - Phone:504-897-8568
Practice Address - Fax:504-897-7008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOURO INFIRMARY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-04
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA197283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1761486Medicaid
LA1761486Medicaid