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General NPI Number Information
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NPI Number | 1235569385
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Entity Type | Organization
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Legal Business Name | REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 3611 TRANSMITTER RD
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City | PANAMA CITY
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State | FL
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Zip | 32404-9799
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Country | US
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Telephone | 850-747-9688
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Fax |
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Provider Business Mailing Address
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Address Line | 3611 TRANSMITTER RD
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City | PANAMA CITY
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State | FL
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Zip | 32404-9799
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Country | US
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Telephone | 850-747-9688
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. RANDALL MCELHENEY
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Credential |
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Telephone | 850-747-9688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF130470978
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License Number State | FL
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