Provider Demographics
NPI:1801831417
Name:RICHLAND PARISH REHABILITATION HOSPITAL, LLC
Entity Type:Organization
Organization Name:RICHLAND PARISH REHABILITATION HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:VARISCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-993-0993
Mailing Address - Street 1:307 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-2531
Mailing Address - Country:US
Mailing Address - Phone:318-728-4410
Mailing Address - Fax:318-728-9844
Practice Address - Street 1:307 HAYES ST
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-2531
Practice Address - Country:US
Practice Address - Phone:318-728-4410
Practice Address - Fax:318-728-9844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA467283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1700533Medicaid
LA193075Medicare ID - Type Unspecified