Provider Demographics
NPI:1417554908
Name:CARROLL HEALTH AND REHAB LLC
Entity Type:Organization
Organization Name:CARROLL HEALTH AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-251-5131
Mailing Address - Street 1:307 N CASTLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:LA
Mailing Address - Zip Code:71263-8894
Mailing Address - Country:US
Mailing Address - Phone:318-428-3249
Mailing Address - Fax:318-428-7547
Practice Address - Street 1:307 N CASTLEMAN ST
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:LA
Practice Address - Zip Code:71263-8894
Practice Address - Country:US
Practice Address - Phone:318-428-3249
Practice Address - Fax:318-428-7547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility