MEDICARE: ACSR INC

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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1154495190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACSR INC

Provider Business Mailing Address
First Line	:	400 REDLAND CT
Second Line	:	SUITE 114
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-3270
Country	:	US
Telephone Number	:	443-548-2200
Fax Number	:	443-548-2260

Provider Business Practice Location Address
First Line	:	5001 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6515
Country	:	US
Telephone Number	:	954-983-2742
Fax Number	:	954-983-2754

Authorized Official
Title or Position	:	CHAIRMAN CEO PRESIDENT
Name	:	MR. KRIS WAYNE BALDOCK
Credential	:
Telephone Number	:	443-548-2200

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	08/22/2020

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