Healthcare Provider Details

I. General information

NPI: 1477002855
Provider Name (Legal Business Name): SOUTHPOINTE REHAB CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AMITY ST
FALL RIVER MA
02721-2202
US

IV. Provider business mailing address

320 NORWOOD PARK S
NORWOOD MA
02062-4659
US

V. Phone/Fax

Practice location:
  • Phone: 508-235-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID BERKOWITZ
Title or Position: MEMBER
Credential:
Phone: 847-262-3800