=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699091496
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABSOLUTIONSKC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2010
-----------------------------------------------------
Last Update Date | 11/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2275 W LAYTON DR
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66061-6859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-638-0497
-----------------------------------------------------
Fax | 913-839-1516
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2275 W LAYTON DR
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66061-6859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-638-0497
-----------------------------------------------------
Fax | 913-839-1516
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST
-----------------------------------------------------
Name | CYNTHIA D. BRISCOE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 913-638-0497
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 2000162963
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1102810
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------