MEDICARE: SAINT ALPHONSUS REGIONAL REHABILITATION HOSPITAL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283X00000X	Rehabilitation Hospital	PENDING	ID

General Provider Information

NPI Number	:	1265921456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT ALPHONSUS REGIONAL REHABILITATION HOSPITAL, LLC

Provider Business Mailing Address
First Line	:	9001 LIBERTY PARKWAY
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-7509
Country	:	US
Telephone Number	:	205-967-7116
Fax Number	:	205-262-3666

Provider Business Practice Location Address
First Line	:	711 NORTH CURTIS ROAD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83706-0000
Country	:	US
Telephone Number	:	205-967-7116
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OF THE MANAGER
Name	:	CAREY BENNETT MCRAE
Credential	:
Telephone Number	:	205-970-3442

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	01/17/2025

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