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NPI Code Detail

MEDICARE: TIAPS REHAB CENTER LLC

MEDICARE: TIAPS REHAB CENTER 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1770168627
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIAPS REHAB CENTER LLC
Provider Business Mailing Address
First Line : 1530 NE GRAND BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73117-5212
Country : US
Telephone Number : 405-681-1155
Fax Number : 405-768-1156
Provider Business Practice Location Address
First Line : 1530 NE GRAND BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73117-5212
Country : US
Telephone Number : 405-681-1155
Fax Number : 405-768-1156
Authorized Official
Title or Position : MANAGER OF SELECTIS MANAGEMENT, LLC
Name : LANCE BALLER
Credential :
Telephone Number : 303-449-2100
Provider Enumeration Date : 03/12/2021
Last Update Date : 04/09/2021

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Directions to “TIAPS REHAB CENTER LLC ” Practice Location

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