Provider Demographics
NPI:1881752285
Name:ACADIA REHABILITATION HOSPITAL, LLC
Entity type:Organization
Organization Name:ACADIA REHABILITATION HOSPITAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-616-0115
Mailing Address - Street 1:203 E. NEQUPQUE STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-5351
Mailing Address - Country:US
Mailing Address - Phone:337-616-0115
Mailing Address - Fax:337-616-0117
Practice Address - Street 1:2018 VETERAN MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-2018
Practice Address - Country:US
Practice Address - Phone:337-898-9191
Practice Address - Fax:337-898-9246
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACADIA REHABILITATION HOSPITAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-05
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA958251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1400408Medicaid
197769Medicare Oscar/Certification