Healthcare Provider Details

I. General information

NPI: 1083487169
Provider Name (Legal Business Name): CLEARSKY REHABILITATION HOSPITAL OF LANCASTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 RIVER VALLEY BLVD
LANCASTER OH
43130-1653
US

IV. Provider business mailing address

5600 WYOMING BLVD NE STE 225
ALBUQUERQUE NM
87109-3136
US

V. Phone/Fax

Practice location:
  • Phone: 740-303-4300
  • Fax: 740-303-4333
Mailing address:
  • Phone: 303-845-0223
  • Fax: 833-642-0408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRISTI DUNCAN
Title or Position: CFO
Credential:
Phone: 505-317-3988