MEDICARE: MOBILITY REHAB 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1487145918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILITY REHAB LLC

Provider Business Mailing Address
First Line	:	PO BOX 1227
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39158-1227
Country	:	US
Telephone Number	:	601-209-7697
Fax Number	:	601-487-6169

Provider Business Practice Location Address
First Line	:	5801 EASTDALE DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-2158
Country	:	US
Telephone Number	:	601-573-9974
Fax Number	:	601-487-8546

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SARAH BECKSTEAD
Credential	:
Telephone Number	:	601-209-7697

Provider Enumeration Date	:	05/21/2018
Last Update Date	:	07/13/2020

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Directions to “MOBILITY REHAB LLC ” Practice Location

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