Organization · NPI-2
Kailo Ltac Hospital, LLC
Special Hospital · Crowley, LA
NPI number1457313827
StatusActive
Last updated in NPPESJan 22, 2013
Details
- NPI
- 1457313827
- Entity type
- Organization (NPI-2)
- Legal business name
- Kailo Ltac Hospital, LLC
- Organization subpart
- No
- Enumeration date
- Apr 3, 2006
- Last updated
- Jan 22, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 284300000X | Special Hospital | 532 | LA | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | 532 | LA |
Other names
- Crowley Rehab Hospital, LLC (Former Legal Business Name)
Practice location
713 N Avenue LCrowley, LA 70526-3832
Phone 337-783-2859 · Fax 337-783-2891
Mailing address
713 N Avenue LCrowley, LA 70526-3832
Phone 337-783-2859 · Fax 337-783-2891
Authorized official
E. Paul Broussard
Ceo/Cfo
3377883600
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