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General NPI Number Information
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NPI Number | 1174783583
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Entity Type | Organization
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Legal Business Name | 21ST CENTURY REHAB PC
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1507 N 1ST ST
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City | INDIANOLA
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State | IA
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Zip | 50125-3703
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Country | US
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Telephone | 515-961-7435
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Fax | 515-961-7436
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Provider Business Mailing Address
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Address Line | PO BOX 461
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City | NEVADA
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State | IA
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Zip | 50201-0461
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Country | US
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Telephone | 515-382-3366
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Fax | 515-382-1576
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Authorized Official
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Title or Position | CFO
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Name | MICHELLE R CASSABAUM
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Credential |
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Telephone | 515-382-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | IA
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