Provider Demographics
NPI:1720434137
Name:D N L OUTPATIENT REHAB, LLC
Entity Type:Organization
Organization Name:D N L OUTPATIENT REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-461-3041
Mailing Address - Street 1:3852 HIGHWAY 171 APT 401
Mailing Address - Street 2:
Mailing Address - City:GLOSTER
Mailing Address - State:LA
Mailing Address - Zip Code:71030-3344
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:671 HWY 171 SUITE C
Practice Address - Street 2:
Practice Address - City:STONEWALL
Practice Address - State:LA
Practice Address - Zip Code:71078-3312
Practice Address - Country:US
Practice Address - Phone:318-775-4124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health