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NPI Code Detail

MEDICARE: PENNSYLVANIA REHAB LP

MEDICARE: PENNSYLVANIA REHAB LP
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 Facility117489TX

General Provider Information

NPI Number : 1558394056
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENNSYLVANIA REHAB LP
Provider Business Mailing Address
First Line : 901 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2226
Country : US
Telephone Number : 817-335-3030
Fax Number : 817-335-2518
Provider Business Practice Location Address
First Line : 901 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2226
Country : US
Telephone Number : 817-335-3030
Fax Number : 817-335-2518
Authorized Official
Title or Position : PRESIDENT
Name : DENISE L DEAPEN
Credential :
Telephone Number : 817-335-3030
Provider Enumeration Date : 07/08/2006
Last Update Date : 08/22/2020

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Directions to “PENNSYLVANIA REHAB LP ” Practice Location

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