Provider Demographics
NPI:1811004211
Name:TOTAL REHAB OF BATON ROUGE
Entity Type:Organization
Organization Name:TOTAL REHAB OF BATON ROUGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-926-8880
Mailing Address - Street 1:9534 DELCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4122
Mailing Address - Country:US
Mailing Address - Phone:225-926-8880
Mailing Address - Fax:225-928-4122
Practice Address - Street 1:9534 DELCOURT AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4122
Practice Address - Country:US
Practice Address - Phone:225-926-8880
Practice Address - Fax:225-928-4122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT07341225100000X
LAOTT.200079225X00000X
LA194516261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1693081Medicaid
LA194516Medicare ID - Type UnspecifiedPROVIDER