Provider Demographics
NPI:1457860777
Name:CRANE REHAB CENTER LLC
Entity Type:Organization
Organization Name:CRANE REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMMUNICATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-866-6990
Mailing Address - Street 1:1055 SAINT CHARLES AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-3981
Mailing Address - Country:US
Mailing Address - Phone:504-293-2454
Mailing Address - Fax:504-828-8935
Practice Address - Street 1:1055 SAINT CHARLES AVE STE 100
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3981
Practice Address - Country:US
Practice Address - Phone:504-293-2454
Practice Address - Fax:504-828-8935
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRANE REHAB CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C526Medicaid