1. Home
  2. Directory
  3. Arkansas
  4. Lake Village
  5. Clinic Center
  6. NPI Profile

SOUTHEAST RURAL HEALTH CLINIC
NPI 1194358523
Clinic/Center - Rural Health in Lake Village, AR

Active since February 13, 2020CLIA Certified · 2 labs
608 S HIGHWAY 65 82, LAKE VILLAGE, AR 71653(870) 265-4333(318) 665-9950 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 24, 2023, Feb 13, 2020 (2 updates tracked since 2020).

About Southeast Rural Health Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST RURAL HEALTH CLINIC (NPI 1194358523) is a healthcare organization registered as a rural health in Lake Village, Arkansas and active in the NPI registry since February 2020. The organization holds 2 active CLIA laboratory certificates and lists Catherine Martin Waldrop, Administrator, as its authorized official.

NPPES Registry Identity

NPI1194358523
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSOUTHEAST REHAB LLC
Location Address608 S HIGHWAY 65 82Lake Village, AR 71653-1743
Mailing AddressPo Box 743Lake Village, AR 71653-0743 · (318) 665-9950 · Fax (318) 665-0379
Phone(870) 265-4333
Fax(318) 665-9950
Organization SubpartYes
Authorized OfficialCatherine Martin WaldropAdministrator · (318) 665-9950
Enumeration DateFebruary 13, 2020
Last NPPES UpdateMarch 24, 20232 updates tracked since enumeration
NPPES CertifiedMarch 24, 2023
✔ NPI 1194358523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedRehabilitation HospitalTaxonomy 283X00000X
608 S HIGHWAY 65 82, Lake Village, AR 71653
Open in Google Maps ↗

Other Names 1

Doing Business AsSoutheast Rural Health Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2183693

Southeast Rural Health Clinic · Lake Village, AR
Active · expires May 7, 2028
CLIA Number04D2183693
Laboratory TypeRural Health Clinic
Certificate Effective DateMay 8, 2026
Certificate Expiration DateMay 7, 2028
Laboratory DirectorDr. John R. Russell
Laboratory Phone(870) 265-4333
Laboratory LocationSoutheast Rural Health Clinic608 Hwy 65 & 82, Lake Village, AR 71653
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 04D1059020

Southeast Rehabilitation Hospital · Lake Village, AR
Active · expires Sep 19, 2026
CLIA Number04D1059020
Laboratory TypeHospital
Certificate Effective DateSeptember 20, 2024
Certificate Expiration DateSeptember 19, 2026
Laboratory DirectorDr. John R. Russell
Laboratory Phone(870) 265-4333
Laboratory LocationSoutheast Rehabilitation Hospital905 Borgognoni Dr, Lake Village, AR 71653
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TEQUESHIA Z MCKOY AT
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711
RONICIA JOHNSON CUNNINGHAM
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711
LAURA BROOKE FLEMISTER-SMITH
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711
TARSHA R PERRY AT
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711
MARY A SANDERS
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711
ATAVIA WHITFIELD MHPP
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711
FANNIE BOLDEN AT
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711
MS. CHERYL A COLE
Counselor
608 S HIGHWAY 65 82, STE B
LAKE VILLAGE, AR 71653
Chicot County (870) 265-3711

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Rehab LLC's NPI number?

The NPI number for Southeast Rehab LLC is 1194358523. It was assigned to this organization in the NPPES registry on February 13, 2020. The provider is doing business as Southeast Rural Health Clinic.

Where is Southeast Rehab LLC located?

Southeast Rehab LLC is located at 608 S Highway 65 82, Lake Village, AR 71653. The listed phone number is (870) 265-4333.

What is Southeast Rehab LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Southeast Rehab LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Southeast Rehab LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Southeast Rehab LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeast Rehab LLC was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.