MEDICARE: SCENIC WELLNESS & REHABILITATION LLC

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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1235930082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCENIC WELLNESS & REHABILITATION LLC

Provider Business Mailing Address
First Line	:	1333 SCENIC DR
Second Line	:
City	:	HERCULANEUM
State	:	MO
Zip	:	63048-1550
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1333 SCENIC DR
Second Line	:
City	:	HERCULANEUM
State	:	MO
Zip	:	63048-1550
Country	:	US
Telephone Number	:	636-931-2995
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. DAVID GARETZ
Credential	:
Telephone Number	:	323-987-5954

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	09/11/2025

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