MEDICARE: POSEY COUNTY REHABILITATION SERVICES

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1063562122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSEY COUNTY REHABILITATION SERVICES

Provider Business Mailing Address
First Line	:	5525 INDUSTRIAL RD
Second Line	:
City	:	MOUNT VERNON
State	:	IN
Zip	:	47620-7200
Country	:	US
Telephone Number	:	812-838-0636
Fax Number	:	812-838-0571

Provider Business Practice Location Address
First Line	:	5525 INDUSTRIAL RD
Second Line	:
City	:	MOUNT VERNON
State	:	IN
Zip	:	47620-7200
Country	:	US
Telephone Number	:	812-838-0636
Fax Number	:	812-838-0571

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JACQUELINE LEE VERVILLE
Credential	:	M.S.
Telephone Number	:	812-838-0636

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	08/22/2020

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