Healthcare Provider Details

I. General information

NPI: 1851921571
Provider Name (Legal Business Name): BHSM REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 E WILLETTA ST
PHOENIX AZ
85006-2723
US

IV. Provider business mailing address

4714 GETTYSBURG RD ATTN MELANIE NOTARIO
MECHANICSBURG PA
17055
US

V. Phone/Fax

Practice location:
  • Phone: 717-972-1100
  • Fax:
Mailing address:
  • Phone: 717-972-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOHN DUGGAN
Title or Position: VP
Credential:
Phone: 717-972-1100