Healthcare Provider Details

I. General information

NPI: 1609149897
Provider Name (Legal Business Name): GATEWAY REHABILITATION HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5940 MERCHANTS ST
FLORENCE KY
41042-1158
US

IV. Provider business mailing address

2200 ROSS AVE SUITE 3060
DALLAS TX
75201-2708
US

V. Phone/Fax

Practice location:
  • Phone: 859-426-2400
  • Fax: 859-426-2419
Mailing address:
  • Phone: 469-621-6707
  • Fax: 469-621-6678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. KURT J. SCHULTZ
Title or Position: CHIEF FINANCIAL OFFIER
Credential:
Phone: 469-621-6707