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SOUTHEAST REHABILITATION HOSPITAL
NPI 1942658729
Family Medicine - Adult Medicine in Lake Village, AR

Active since June 02, 2016
903 BORGOGNONI DR, LAKE VILLAGE, AR 71653(870) 265-4333(318) 665-0379 Get Directions Write a Review

NPPES record last updated: June 28, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Southeast Rehabilitation Hospital NPPES

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

SOUTHEAST REHABILITATION HOSPITAL (NPI 1942658729) is a healthcare organization registered as an adult medicine in Lake Village, Arkansas and active in the NPI registry since June 2016. The organization lists Cathy M Waldrop, Chairman, as its authorized official.

NPPES Registry Identity

NPI1942658729
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameSOUTHEAST REHAB LLC
Location Address903 BORGOGNONI DRLake Village, AR 71653-1623
Mailing Address903 Borgognoni DrLake Village, AR 71653-1623 · (318) 665-9950 · Fax (318) 665-0379
Phone(870) 265-4333
Fax(318) 665-0379
Organization SubpartNo
Authorized OfficialCathy M WaldropChairman · (318) 665-9950
Enumeration DateJune 2, 2016
Last NPPES UpdateJune 28, 2019
✔ NPI 1942658729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
903 BORGOGNONI DR, Lake Village, AR 71653
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Other Names 1

Doing Business AsSoutheast Rehabilitation Hospital

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

CHICOT OPERATIONS, LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337
SOUTHEAST REHAB LLC.
Nurse Practitioner (Gerontology)
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (318) 665-9950
CHICOT SNF OPERATIONS LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337
JSKMF, LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337
LAKE VILLAGE OPERATIONS LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337

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 1942658729. It was assigned to this organization in the NPPES registry on June 2, 2016.

Where is Southeast Rehab LLC located?

Southeast Rehab LLC is located at 903 Borgognoni Dr, 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 Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Southeast Rehab LLC was last updated on June 28, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.