Provider Demographics
NPI:1649455312
Name:THE NEXT LEVEL PERFORMANCE AND REHABILITATION CENTER LLC
Entity type:Organization
Organization Name:THE NEXT LEVEL PERFORMANCE AND REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SILVESTRI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:985-373-8263
Mailing Address - Street 1:610 DEER CROSS CT E
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3338
Mailing Address - Country:US
Mailing Address - Phone:985-898-0721
Mailing Address - Fax:985-898-0725
Practice Address - Street 1:610 DEER CROSS CT. E
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447
Practice Address - Country:US
Practice Address - Phone:985-373-8263
Practice Address - Fax:985-893-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01420261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DD23Medicare PIN