Healthcare Provider Details

I. General information

NPI: 1386655272
Provider Name (Legal Business Name): COMPREHENSIVE REHAB INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 11/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1377 11TH ST NW
CLINTON IA
52732-5068
US

IV. Provider business mailing address

1377 11TH ST NW
CLINTON IA
52732-5068
US

V. Phone/Fax

Practice location:
  • Phone: 563-241-4230
  • Fax: 563-519-4235
Mailing address:
  • Phone: 563-241-4230
  • Fax: 563-519-4235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: BILLIE JO HORNER
Title or Position: SECRETARY /TREASURER
Credential:
Phone: 563-241-4230