Healthcare Provider Details

I. General information

NPI: 1043275936
Provider Name (Legal Business Name): SENIORHEALTH REHABILITATION HOSPITAL OF GREENVILLE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4215 JOE RAMSEY BLVD E
GREENVILLE TX
75401-7852
US

IV. Provider business mailing address

4215 JOE RAMSEY BLVD E
GREENVILLE TX
75401-7852
US

V. Phone/Fax

Practice location:
  • Phone: 903-408-1781
  • Fax: 903-408-1721
Mailing address:
  • Phone: 903-408-1781
  • Fax: 903-408-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number008232
License Number StateTX

VIII. Authorized Official

Name: MS. LORRAINE COOK
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 903-408-1781