Provider Demographics
NPI:1073658001
Name:INTEGRA HOSPITAL BATON ROUGE, LLC
Entity Type:Organization
Organization Name:INTEGRA HOSPITAL BATON ROUGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-403-1860
Mailing Address - Street 1:6900 N DALLAS PKWY
Mailing Address - Street 2:SUITE 740
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8000 SUMMA AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3423
Practice Address - Country:US
Practice Address - Phone:225-766-0130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA474283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19-3078Medicare ID - Type Unspecified