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General NPI Number Information
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NPI Number | 1003375411
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Entity Type | Organization
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Legal Business Name | NEURO REHABCARE-TASS
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 512 HARMONY ROAD
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City | CRYSTAL SPRINGS
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State | MS
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Zip | 39059
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Country | US
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Telephone | 601-892-4384
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Fax | 601-892-4386
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Provider Business Mailing Address
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Address Line | 512 HARMONY ROAD
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City | CRYSTAL SPRINGS
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State | MS
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Zip | 39059
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Country | US
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Telephone | 601-892-4384
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Fax | 601-892-4386
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JEFF STANFORD
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Credential | M.A.
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Telephone | 601-892-4384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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