Healthcare Provider Details
I. General information
NPI: 1821531690
Provider Name (Legal Business Name): RECOVER-CARE WATHENA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2016
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2112 HIGHWAY 36
WATHENA KS
66090-4126
US
IV. Provider business mailing address
3009 QUENTIN RD 2ND FLOOR
BROOKLYN NY
11234-4246
US
V. Phone/Fax
- Phone: 785-989-3141
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZISHA
MARGULIES
Title or Position: CEO
Credential:
Phone: 718-942-3483