=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689648339
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CMS REHAB OF WF LP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2006
-----------------------------------------------------
Last Update Date | 01/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3901 ARMORY RD
-----------------------------------------------------
City | WICHITA FALLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-720-5700
-----------------------------------------------------
Fax | 940-720-5765
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9001 LIBERTY PARKWAY
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-7509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-967-7116
-----------------------------------------------------
Fax | 205-969-6650
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT OF THE GENERAL PARTN
-----------------------------------------------------
Name | MR. CAREY BENNETT MCRAE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 205-970-3442
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 283X00000X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Hospital
-----------------------------------------------------
License Number | 685
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------