Healthcare Provider Details

I. General information

NPI: 1801301437
Provider Name (Legal Business Name): COMMUNITY STROKE AND REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10215 BROADWAY
CROWN POINT IN
46307-8001
US

IV. Provider business mailing address

PO BOX 3032
MUNSTER IN
46321-0032
US

V. Phone/Fax

Practice location:
  • Phone: 219-661-6100
  • Fax:
Mailing address:
  • Phone: 219-934-8888
  • Fax: 219-934-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHAR KULLERSTRAND
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 219-934-8994