OrganizationActive
Magnolia Rehabilitation Services Inc
NPI 1881691194 · Multi-Specialty Clinic/Center · Shreveport, LA
Provider details
- NPI number
- 1881691194
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Dewarrent Brantley, Owner/Ceo(318) 840-9074
Specialties & taxonomies
Ambulatory Health Care Facilities
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Practice location
4005 Lakeshore Dr
Shreveport, LA 71109-1927
Phone: (337) 324-8465
Fax: (318) 676-3083
Approximate (ZIP-level) locationGet directions
Mailing address
4005 Lakeshore Dr
Shreveport, LA 71109-1927
Additional practice locations (1)
- 680 Broadway Ste 68Paterson, NJ 07514-1524Phone: (318) 840-9074
Registry dates
- Enumerated
- 2005-06-30
- Last updated
- 2025-06-04
- Certified
- 2025-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.