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NPI Code Detail

MEDICARE: GL REHABILITATION

MEDICARE: GL 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
1314000000XSkilled Nursing Facility4623-026WI

General Provider Information

NPI Number : 1063678928
Entity Type Code : Organization
Provider Name (Legal Business Name) : GL REHABILITATION
Provider Business Mailing Address
First Line : 2620 WAUNONA WAY
Second Line :
City : MADISON
State : WI
Zip : 53713-1525
Country : US
Telephone Number : 608-223-1452
Fax Number :
Provider Business Practice Location Address
First Line : 2620 WAUNONA WAY
Second Line :
City : MADISON
State : WI
Zip : 53713-1525
Country : US
Telephone Number : 608-223-1452
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : SHANLEY HAMILTON
Credential : M.S.
Telephone Number : 608-217-5460
Provider Enumeration Date : 07/31/2008
Last Update Date : 07/31/2008

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Directions to “GL REHABILITATION ” Practice Location

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