Basic Information
| Provider Information | |||||||||
| NPI: | 1013166388 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HIGH HOPE REHABILITATION AND NURSING CENTER LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HIGH HOPE REHABILITATION AND NURSING CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 475 HIGH HOPE RD | ||||||||
| Address2: | |||||||||
| City: | SULPHUR | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706630037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375278140 | ||||||||
| FaxNumber: | 3375270098 | ||||||||
| Practice Location | |||||||||
| Address1: | 475 HIGH HOPE RD | ||||||||
| Address2: | |||||||||
| City: | SULPHUR | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706630037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375278140 | ||||||||
| FaxNumber: | 3375270098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2008 | ||||||||
| LastUpdateDate: | 09/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | BROUSSARD | ||||||||
| AuthorizedOfficialFirstName: | KENDALL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 3374396600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 687 | LA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.