Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Magnolia Rehabilitation Services Inc

Organization Clinic/Center · NPI 1881691194

Magnolia Rehabilitation Services Inc is a Clinic/Center in Shreveport, Louisiana. Works from 2 locations. Licensed in Louisiana.

Licensed in
LA
In the registry since
2005
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4005 Lakeshore Dr
Shreveport, LA 71109-1927
Phone: (337) 324-8465
Fax: (318) 676-3083
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 680 Broadway Ste 68, Paterson, NJ 07514-1524 — (318) 840-9074

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X · Licence 5CF64 (LA)
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1881691194
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dewarrent Brantley — Owner/Ceo · (318) 840-9074
NPI enumeratedJune 30, 2005
Last updated in NPPESJune 4, 2025
Certification dateJune 4, 2025
Mailing address4005 Lakeshore Dr, Shreveport, LA 71109-1927

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