Provider Demographics
NPI:1790949287
Name:RAR, INC.
Entity Type:Organization
Organization Name:RAR, INC.
Other - Org Name:GREENACRES CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROUGEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-747-4433
Mailing Address - Street 1:925 BENTON RD
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3603
Mailing Address - Country:US
Mailing Address - Phone:318-747-4433
Mailing Address - Fax:318-747-4454
Practice Address - Street 1:925 BENTON RD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3603
Practice Address - Country:US
Practice Address - Phone:318-747-4433
Practice Address - Fax:318-747-4454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1168211Medicaid
LAU77195Medicare UPIN
LA5P026Medicare PIN