Healthcare Provider Details

I. General information

NPI: 1457573875
Provider Name (Legal Business Name): GREENWOOD REGIONAL REHABILITATION HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 PARKWAY
GREENWOOD SC
29646-4027
US

IV. Provider business mailing address

1024 N GALLOWAY AVE STE 102
MESQUITE TX
75149-2434
US

V. Phone/Fax

Practice location:
  • Phone: 505-856-5300
  • Fax: 505-856-6800
Mailing address:
  • Phone: 972-216-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DENISE KANN
Title or Position: VICE PRESIDENT AND SECRETARY
Credential:
Phone: 972-216-2299