Healthcare Provider Details

I. General information

NPI: 1740514850
Provider Name (Legal Business Name): REHABCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 WATSON RD
SAINT LOUIS MO
63119-5001
US

IV. Provider business mailing address

1239 GARDEN CIRCLE DR APT F
SAINT LOUIS MO
63125-3574
US

V. Phone/Fax

Practice location:
  • Phone: 314-961-8000
  • Fax: 314-918-1250
Mailing address:
  • Phone: 314-704-1652
  • Fax: 314-918-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2007037087
License Number StateMO

VIII. Authorized Official

Name: MISS JENNIFER LYNN DELF
Title or Position: PHYSICAL THERAPIST
Credential: MPT
Phone: 314-704-1652