SOUTHEAST REHAB LLC (NPI# 1700959905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700959905 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST REHAB LLC |
| Other Organization Name | SOUTHEAST REHABILITATION HOSPITAL |
| Practice Address |
903 Borgognoni Dr Lake Village AR 71653-1623 |
| Practice Telephone | 3186659950 |
| Practice Fax Number | 3186650379 |
| Mailing Telephone | 3186659950 |
| Mailing Fax Number | 3186650379 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2019-06-28 |
| Authorized Official Name | CATHERINE MARTIN WALDROP (ADMINISTRATOR/CEO) |
| Authorized Official Telephone | 3186659950 |
| Authorized Official Credential | MED, LPC, NBCC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283X00000X | Rehabilitation Hospital | AR4376 | AR | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 163180526 | 05 |
| Other Name | Type Code |
|---|---|
| Southeast Rehabilitation Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629307137 | Southeast Rehab LLC | Clinic/Center | 2555 Meridian Blvd, Ste. 330, Franklin, TN 37067-6363 | 2009-12-11 |
| 1194358523 | Southeast Rehab LLC | Rehabilitation Hospital | 608 S Highway 65 82, Lake Village, AR 71653-1743 | 2020-02-13 |
| 1942658729 | Southeast Rehab LLC | Physician Assistant | 903 Borgognoni Dr, Lake Village, AR 71653-1623 | 2016-06-02 |
| Street Address |
903 BORGOGNONI DR |
| City | LAKE VILLAGE |
| State | AR |
| Zip Code | 71653-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295276970 | Southeast Rehab LLC. | Nurse Practitioner | 903 Borgognoni Dr, Lake Village, AR 71653-1623 | 2017-03-15 |
| 1942658729 | Southeast Rehab LLC | Physician Assistant | 903 Borgognoni Dr, Lake Village, AR 71653-1623 | 2016-06-02 |
| 1700193133 | Chicot Snf Operations LLC | Skilled Nursing Facility | 903 Borgognoni Dr, Lake Village, AR 71653-1623 | 2010-09-07 |
| 1376863597 | Chicot Operations, LLC | Skilled Nursing Facility | 903 Borgognoni Dr, Lake Village, AR 71653-1623 | 2010-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500192 | Ashley Brown | Speech-Language Pathologist | 336 Us-82, Lake Village, AR 71653 | 2020-08-26 |
| 1861901985 | Chicot Memorial Medical Center | Clinic/Center | 2729 S. Hwy 65 82, Lake Village, AR 71653 | 2017-09-20 |
| 1326586173 | Mainline Health Systems, Inc | Clinic/Center | 360 A Hwy 82, Lake Village, AR 71653 | 2017-02-01 |
| 1508303124 | Mainline Health Systems, Inc | Clinic/Center | 360 A Highway 82, Lake Village, AR 71653 | 2017-01-20 |
| 1689120263 | Russell Medical Services Pllc | Family Medicine | 5071 Highway 82 E, Lake Village, AR 71653 | 2016-09-01 |
| 1528362035 | Hillman Chiropractic LLC | Chiropractor | 2819 Louis Sessions Dr., Lake Village, AR 71653 | 2010-12-28 |
| 1902113913 | Sheri K Bagwell | Counselor | 1127 Second St., Lake Village, AR 71653 | 2010-09-13 |
| 1205154044 | Arkansas Department of Health | Public Health or Welfare | 1742 Hwy 65 and 82 South, Lake Village, AR 71653 | 2010-05-04 |
| 1114259041 | William Jackson Weaver | General Practice | 1754 Lake Hall Road, Lake Village, AR 71653 | 2010-02-03 |
| 1821246992 | Maurenella Antionette Nelson | Social Worker | 1127 Second Street, Lake Village, AR 71653 | 2008-09-03 |
| Find all providers in zip 71653 | ||||
| Taxonomy Code | 283X00000X |
| Grouping | Hospitals |
| Classification | 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. |
| Notes: Source: Joint Commission on Accreditation of Healthcare Organizations, Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Oakbrook Terrace, IL: 1994, p. 323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358523 | Southeast Rehab LLC | Rehabilitation Hospital | 608 S Highway 65 82, Lake Village, AR 71653-1743 | 2020-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114254406 | Levi Hospital | Rehabilitation Hospital | 130 Werner St, Hot Springs, AR 71913-6443 | 2009-11-09 |
| 1619941556 | Cms Jonesboro Rehabilitation Inc | Rehabilitation Hospital | 1201 Fleming Ave, Jonesboro, AR 72401-4311 | 2006-02-15 |
| 1639142342 | Encompass Health Rehabilitation Hospital of Fort Smith, LLC | Rehabilitation Hospital | 1401 S J St, Fort Smith, AR 72901-5158 | 2006-02-12 |
| 1699322164 | Everest Rehabilitation Hospital Bentonville, LLC | Rehabilitation Hospital | 4313 S. Pleasant Crossing Blvd., Rogers, AR 72758 | 2019-08-20 |
| 1346623352 | Central Arkansas Rehabilitation Associates, L.p. | Rehabilitation Hospital | 1636 Higdon Ferry Rd, Hot Springs, AR 71913-6912 | 2015-07-08 |
| 1114361425 | Chris Andrew Whaley | Rehabilitation Hospital | 9601 Interstate 630, Little Rock, AR 72205 | 2013-04-18 |
| 1417292608 | Encompass Health Rehabilitation Hospital of Jonesboro, LLC | Rehabilitation Hospital | 1201 Fleming Ave, Jonesboro, AR 72401-4311 | 2012-11-29 |
| 1588849665 | Fort Smith Hma, LLC | Rehabilitation Hospital | 1001 Towson Ave, Fort Smith, AR 72901-4921 | 2008-01-08 |
| 1316162852 | Hot Springs Rehabilitation Center Hospital | Rehabilitation Hospital | 105 Reserve St, Hot Springs, AR 71901-4195 | 2007-04-17 |
| 1356565428 | White River Health System | Rehabilitation Hospital | 1699 Harrison St, 1699 Harrison St., Batesville, AR 72501-7302 | 2007-04-12 |
| Find all providers with the same taxonomy | ||||
| City | LAKE VILLAGE |
| Zip Code | 71653 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.