Healthcare Provider Details

I. General information

NPI: 1205962537
Provider Name (Legal Business Name): ENCORE REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 MILL STREET EXT # B
LUCEDALE MS
39452-6064
US

IV. Provider business mailing address

251 JOHNSTON ST SE STE 300
DECATUR AL
35601-2535
US

V. Phone/Fax

Practice location:
  • Phone: 601-947-9005
  • Fax: 601-947-9007
Mailing address:
  • Phone: 256-350-1764
  • Fax: 256-274-0234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL G HENDERSON
Title or Position: PRESIDENT
Credential: PT
Phone: 256-350-1764