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MAGNOLIA REHABILITATION SERVICES INC
NPI 1881691194
Clinic/Center - Multi-Specialty in Shreveport, LA

Active since June 30, 2005
4005 LAKESHORE DR, SHREVEPORT, LA 71109(337) 324-8465(318) 676-3083 Get Directions Write a Review

NPPES record last updated: June 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 4, 2025, Feb 5, 2025 (2 updates tracked since 2025).

About Magnolia Rehabilitation Services Inc NPPES

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

MAGNOLIA REHABILITATION SERVICES INC (NPI 1881691194) is a healthcare organization registered as a multi-specialty in Shreveport, Louisiana and active in the NPI registry since June 2005. The organization maintains a secondary practice location in Paterson and lists Dewarrent Lee Brantley, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1881691194
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameMAGNOLIA REHABILITATION SERVICES INC
Location Address4005 LAKESHORE DRShreveport, LA 71109-1927
Mailing Address4005 Lakeshore DrShreveport, LA 71109-1927 · (318) 840-9074 · Fax (318) 860-3025
Phone(337) 324-8465
Fax(318) 676-3083
Organization SubpartNo
Authorized OfficialDewarrent Lee BrantleyOwner/ceo · (318) 840-9074
Enumeration DateJune 30, 2005
Last NPPES UpdateJune 4, 20252 updates tracked since enumeration
NPPES CertifiedJune 4, 2025
✔ NPI 1881691194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
License✔ Licensed in LA · 5CF64
Also ListedClinic/CenterTaxonomy 261Q00000X
4005 LAKESHORE DR, Shreveport, LA 71109
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Secondary Practice Location 1

Location 1680 Broadway Ste 68Paterson, NJ 07514-1524 · Phone (318) 840-9074

Other Providers at the Same Location NPPES

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

MAGNOLIA DIAGNOSTIC SERVICES INC.
Nurse Practitioner
4005 LAKESHORE DR
SHREVEPORT, LA 71109
Caddo Parish (318) 840-9074

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 Rehabilitation Services Inc's NPI number?

The NPI number for Magnolia Rehabilitation Services Inc is 1881691194. It was assigned to this organization in the NPPES registry on June 30, 2005.

Where is Magnolia Rehabilitation Services Inc located?

Magnolia Rehabilitation Services Inc is located at 4005 Lakeshore Dr, Shreveport, LA 71109. The listed phone number is (337) 324-8465.

What is Magnolia Rehabilitation Services Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Magnolia Rehabilitation Services Inc was last updated on June 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.