Healthcare Provider Details

I. General information

NPI: 1518832732
Provider Name (Legal Business Name): EXALT HEALTH REHABILITATION HOSPITAL ORANGE PARK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 TAYLOR AVE.
ORANGE PARK FL
32065
US

IV. Provider business mailing address

2306 GUTHRIE RD STE 180
GARLAND TX
75043-5952
US

V. Phone/Fax

Practice location:
  • Phone: 904-639-9001
  • Fax:
Mailing address:
  • Phone: 972-414-6062
  • 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: CHAD DEARDORFF
Title or Position: CFO
Credential:
Phone: 972-414-6062