Healthcare Provider Details

I. General information

NPI: 1609285790
Provider Name (Legal Business Name): 21ST CENTURY REHAB, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 S G AVE
NEVADA IA
50201-2717
US

IV. Provider business mailing address

2350 HOSPITAL DR
WEBSTER CITY IA
50595-6600
US

V. Phone/Fax

Practice location:
  • Phone: 515-382-3366
  • Fax: 515-382-1576
Mailing address:
  • Phone: 515-832-7735
  • Fax: 515-832-7795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number073706
License Number StateIA

VIII. Authorized Official

Name: CHRISTA SKAGGS
Title or Position: HUMAN RESOURCES DIRECTOR
Credential:
Phone: 515-382-3366