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General NPI Number Information
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NPI Number | 1174349997
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Entity Type | Organization
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Legal Business Name | SSM SELECT REHAB ST LOUIS LLC
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 700 S WOODLAWN AVE
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City | O FALLON
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State | MO
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Zip | 63366-3026
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Country | US
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Telephone | 717-972-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 4714 GETTYSBURG RD MELANIE NOTARIO
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City | MECHANICSBURG
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State | PA
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Zip | 17055
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Country | US
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Telephone | 717-972-1100
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Fax |
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Authorized Official
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Title or Position | VP
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Name | JOHN DUGGAN
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Credential |
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Telephone | 717-975-4503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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