Healthcare Provider Details

I. General information

NPI: 1487300943
Provider Name (Legal Business Name): CLEARSKY REHABILITATION HOSPITAL OF ELWOOD ST JOSEPH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2022
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 ROSEPORT RD
ELWOOD KS
66024
US

IV. Provider business mailing address

5600 WYOMING BLVD NE STE 225
ALBUQUERQUE NM
87109-3136
US

V. Phone/Fax

Practice location:
  • Phone: 913-348-4453
  • Fax:
Mailing address:
  • Phone: 303-845-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRISTI DUNCAN
Title or Position: CFO
Credential:
Phone: 505-317-3988