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MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC.
NPI 1407853716
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Shreveport, LA

Active since June 30, 2005
2005 CRESWELL AVE, SHREVEPORT, LA 71104(318) 676-0705(318) 676-0709 Get Directions Write a Review

NPPES record last updated: August 18, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. NPPES

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

MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. (NPI 1407853716) is a healthcare organization registered as a rehabilitation, comprehensive outpatient rehabilitation facility (corf) in Shreveport, Louisiana and active in the NPI registry since June 2005. The organization lists Dewarrent Lee Brantley, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1407853716
Entity TypeOrganization
Primary Taxonomy261QR0401X
Legal Business NameMAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC.
Location Address2005 CRESWELL AVEShreveport, LA 71104-2201
Mailing Address2005 Creswell AveShreveport, LA 71104-2201 · (318) 676-0705 · Fax (318) 676-0709
Phone(318) 676-0705
Fax(318) 676-0709
Organization SubpartNo
Authorized OfficialDewarrent Lee BrantleyCeo/president · (318) 676-0705
Enumeration DateJune 30, 2005
Last NPPES UpdateAugust 18, 2011
✔ NPI 1407853716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Ambulatory Health Care Facilities
Taxonomy Code261QR0401X
2005 CRESWELL AVE, Shreveport, LA 71104
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Other Identifiers 2

Medicaid1159310LA
Other=========0LA · Bluecrossbluesheild Of La

Other Providers at the Same Location NPPES 4

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

MAGNOLIA DIAGONSTIC SERVICES INC.
Clinic/Center (Multi-Specialty)
2005 CRESWELL AVE
SHREVEPORT, LA 71104
Caddo Parish (318) 678-0709
MAGNOLIA TRANSPORTATION SERVICES INC.
Non-emergency Medical Transport (VAN)
2005 CRESWELL AVE
SHREVEPORT, LA 71104
Caddo Parish (318) 678-0709
MAGNOLIA INTERGRATED HEALTHCARE SERVICES INC
Pharmacy (Clinic Pharmacy)
2005 CRESWELL AVE
SHREVEPORT, LA 71104
Caddo Parish (318) 678-0709
MAGNOLIA COMMUNITY MENTAL HEALTH FACILITY INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2005 CRESWELL AVE
SHREVEPORT, LA 71104
Caddo Parish (318) 678-0907

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 Magnolia Comprehensive Outpatient Rehabiliation Facility Inc.'s NPI number?

The NPI number for Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. is 1407853716. It was assigned to this organization in the NPPES registry on June 30, 2005.

Where is Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. located?

Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. is located at 2005 Creswell Ave, Shreveport, LA 71104. The listed phone number is (318) 676-0705.

What is Magnolia Comprehensive Outpatient Rehabiliation Facility Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF), with taxonomy code 261QR0401X.

When was this NPI record last updated?

The NPPES record for Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. was last updated on August 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.