Healthcare Provider Details

I. General information

NPI: 1447507439
Provider Name (Legal Business Name): REHABCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109HOMEWOODBLVD
GLASGOW KY
42141
US

IV. Provider business mailing address

1610 ONEAL RD
ADOLPHUS KY
42120-8784
US

V. Phone/Fax

Practice location:
  • Phone: 270-651-6126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number002602
License Number StateKY

VIII. Authorized Official

Name: MS. JENNIFER SIMMONS
Title or Position: PROGRAMDIRECTOR
Credential:
Phone: 270-791-3193