National Provider Identifier Database

SOUTHEAST REHAB LLC
Rehabilitation Hospital

A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity.


Contact Information

SOUTHEAST REHAB LLC
905 BORGOGNONI DR
LAKE VILLAGE, AR71653-1623
Phone: 318-665-9950
Fax: 318-665-0379
Website:
Specialty Taxonomy Code
* Rehabilitation Hospital 283X00000X

* Indicates primary specialty

NPI Profile & details for SOUTHEAST REHAB LLC

NPI Number 1700959905
Legal business name
LBN
SOUTHEAST REHAB LLC
Authorized official CATHERINE WALDROP - (ADMINISTRATOR/CEO)
Entity Organization
Organization subpart No
Enumeration date 11/16/2006
Last updated 11/07/2025 - About 7 months ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: AR4376
  • AR Medicaid: 163180526

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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