Healthcare Provider Details

I. General information

NPI: 1821345331
Provider Name (Legal Business Name): TRUREHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 OLD BRUCEVILLE RD
VINCENNES IN
47591-3889
US

IV. Provider business mailing address

3801 OLD BRUCEVILLE RD
VINCENNES IN
47591-3889
US

V. Phone/Fax

Practice location:
  • Phone: 812-886-4677
  • Fax:
Mailing address:
  • Phone: 812-886-4677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number146.008180
License Number StateIL

VIII. Authorized Official

Name: MRS. ASHLEY PARRISH
Title or Position: BOM
Credential:
Phone: 812-886-4677