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NPI Code Detail

MEDICARE: GOOD SHEPHERD REHABILITATION INSTITUTE INC.

MEDICARE: GOOD SHEPHERD REHABILITATION INSTITUTE 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
12251C2600XCardiopulmonary Physical Therapist
2225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164605044
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOOD SHEPHERD REHABILITATION INSTITUTE INC.
Provider Business Mailing Address
First Line : P.O. BOX 777851
Second Line :
City : HENDERSON
State : NV
Zip : 89077
Country : US
Telephone Number : 702-893-3333
Fax Number : 702-893-0960
Provider Business Practice Location Address
First Line : 2235 E FLAMINGO RD STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5186
Country : US
Telephone Number : 725-333-7149
Fax Number : 702-893-0960
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. RAUL A ABEJUELA
Credential :
Telephone Number : 702-893-3333
Provider Enumeration Date : 12/13/2007
Last Update Date : 04/18/2018

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Directions to “GOOD SHEPHERD REHABILITATION INSTITUTE INC. ” Practice Location

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