Provider Demographics
NPI:1609801208
Name:JOHN J. HAINKEL, JR. HOME & REHABILITATION CENTER
Entity Type:Organization
Organization Name:JOHN J. HAINKEL, JR. HOME & REHABILITATION CENTER
Other - Org Name:NEW ORLEANS HOME AND REHABILITATION CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LTC HOSPITAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALES
Authorized Official - Suffix:SR
Authorized Official - Credentials:NFA, MPA
Authorized Official - Phone:504-896-1321
Mailing Address - Street 1:612 HENRY CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5818
Mailing Address - Country:US
Mailing Address - Phone:504-896-1321
Mailing Address - Fax:504-896-1329
Practice Address - Street 1:612 HENRY CLAY AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5818
Practice Address - Country:US
Practice Address - Phone:504-896-1321
Practice Address - Fax:504-896-1329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN J HAINKEL HR HOME & REHAB CENTER ADHC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QA0600X
LA32314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1714496Medicaid
LA1515060Medicaid
LA195149Medicare Oscar/Certification