| Southeast Rehab Llc | |
|
608 S Highway 65 82 Lake Village AR 71653-1743 | |
| (870) 265-4333 | |
| (318) 665-9950 |
| Full Name | Southeast Rehab Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 608 S Highway 65 82, Lake Village, Arkansas |
| Authorized Official Name and Position | Catherine Martin Waldrop (ADMINISTRATOR) |
| Authorized Official Contact | 3186659950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Rehab Llc Po Box 743 Lake Village AR 71653-0743 Ph: (318) 665-9950 | Southeast Rehab Llc 608 S Highway 65 82 Lake Village AR 71653-1743 Ph: (870) 265-4333 |
| NPI Number | 1194358523 |
|---|---|
| Provider Enumeration Date | 02/13/2020 |
| Last Update Date | 03/24/2023 |
| Medicare PECOS PAC ID | 6709884604 |
|---|---|
| Medicare Enrollment ID | O20200311000979 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194358523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 283X00000X | Rehabilitation Hospital | (* (Not Available)) | Secondary |
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