Healthcare Provider Details

I. General information

NPI: 1083041776
Provider Name (Legal Business Name): ST MARY REHABILITATION HOSPITAL LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2013
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 NEWTON-LANGHORNE ROAD
LANGHORNE PA
19047
US

IV. Provider business mailing address

1208 NEWTON-LANGHORNE ROAD
LANGHORNE PA
19047
US

V. Phone/Fax

Practice location:
  • Phone: 314-881-4275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LISA HANEY
Title or Position: CEO
Credential:
Phone: 267-688-0711