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NPI Code Detail

MEDICARE: SELECT REHABILITATION

MEDICARE: SELECT REHABILITATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001273OTHERCOMANAGED CARE

General Provider Information

NPI Number : 1033828579
Entity Type Code : Organization
Provider Name (Legal Business Name) : SELECT REHABILITATION
Provider Business Mailing Address
First Line : 4835 TETON PL
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-5234
Country : US
Telephone Number : 719-551-6499
Fax Number :
Provider Business Practice Location Address
First Line : 2365 PATRIOT HTS
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-5122
Country : US
Telephone Number : 719-551-6499
Fax Number :
Authorized Official
Title or Position : SPEECH-LANGUAGE PATHOLOGIST
Name : GAYLA S GRZEGORCZYK
Credential : MA, CCC-SLP
Telephone Number : 719-551-6499
Provider Enumeration Date : 11/22/2022
Last Update Date : 11/22/2022

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Directions to “SELECT REHABILITATION ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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