Healthcare Provider Details

I. General information

NPI: 1235569385
Provider Name (Legal Business Name): REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3611 TRANSMITTER RD
PANAMA CITY FL
32404-9799
US

IV. Provider business mailing address

3611 TRANSMITTER RD
PANAMA CITY FL
32404-9799
US

V. Phone/Fax

Practice location:
  • Phone: 850-747-9688
  • Fax:
Mailing address:
  • Phone: 850-747-9688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF130470978
License Number StateFL

VIII. Authorized Official

Name: MR. RANDALL MCELHENEY
Title or Position: MANAGER
Credential:
Phone: 850-747-9688