National Provider Identifier Database

RIVERSIDE REHABILITATION AGENCY INC
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)


Contact Information

RIVERSIDE REHABILITATION AGENCY, INC.
8680 BLUEBONNET BLVD
SUITE D
BATON ROUGE, LA70810-7825
Phone: 225-936-2021
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X

* Indicates primary specialty

NPI Profile & details for RIVERSIDE REHABILITATION AGENCY, INC.

NPI Number 1720027105
Legal business name
LBN
RIVERSIDE REHABILITATION AGENCY, INC.
Authorized official MARTHA BANKS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/04/2006
Last updated 10/19/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • LA Medicaid: 1566250

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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