MEDICARE: HALSTEAD HOSPITAL & REHABILITATION 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
1	282NR1301X	Rural Acute Care Hospital	384623	KS

General Provider Information

NPI Number	:	1912116120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALSTEAD HOSPITAL & REHABILITATION CENTER, LLC

Provider Business Mailing Address
First Line	:	32 PINE TREE DR
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12603-5224
Country	:	US
Telephone Number	:	845-462-4000
Fax Number	:	845-462-2074

Provider Business Practice Location Address
First Line	:	328 POPLAR ST
Second Line	:
City	:	HALSTEAD
State	:	KS
Zip	:	67056-2014
Country	:	US
Telephone Number	:	845-462-4000
Fax Number	:	845-462-2074

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. AZZY RECKESS
Credential	:
Telephone Number	:	845-462-4000

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	05/03/2011

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