Healthcare Provider Details

I. General information

NPI: 1255808788
Provider Name (Legal Business Name): SELECT REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 SAMPLE ROAD
POMPANO BEACH FL
33064
US

IV. Provider business mailing address

2600 COMPASS RD
GLENVIEW IL
60026-8001
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-4100
  • Fax:
Mailing address:
  • Phone: 877-787-3430
  • Fax: 847-441-0734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JAIME LYNCH
Title or Position: DOR
Credential: ST
Phone: 954-941-4100