SOUTHEAST REHAB LLC; NPI #1700959905

Contact Information

SOUTHEAST REHAB LLC

905 BORGOGNONI DR
LAKE VILLAGE, AR 71653-1623

Phone: 318-665-9950
Fax: 318-665-0379
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation Hospital	283X00000X	A0[7]	Hospital-Rehabilitation (PPS excluded)

Indicates primary specialty

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NPI Profile & details for SOUTHEAST REHAB LLC

NPI # 1700959905

LBN Legal business name SOUTHEAST REHAB LLC

Authorized official CATHERINE WALDROP - (ADMINISTRATOR/CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/16/2006

Last updated 11/07/2025 - About 7 months ago

Identifiers

AR	License #	AR4376
AR	Medicaid	163180526

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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SOUTHEAST REHAB LLC

Contact Information

Specialty

Rehabilitation Hospital

NPI Profile & details for SOUTHEAST REHAB LLC

Reviews for SOUTHEAST REHAB LLC