Healthcare Provider Details
I. General information
NPI: 1922385657
Provider Name (Legal Business Name): REHAB WITHOUT WALLS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2011
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10619 S JORDAN GTWY STE 205
SOUTH JORDAN UT
84095-3969
US
IV. Provider business mailing address
805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-7101
US
V. Phone/Fax
- Phone: 800-244-3221
- Fax:
- Phone: 800-866-0860
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARGARET
S
PEMBERTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-394-2100