MEDICARE: DAYTON REHABILITATION INSTITUTE, 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	283X00000X	Rehabilitation Hospital	HOSPITAL # 1461	OH

General Provider Information

NPI Number	:	1619966231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYTON REHABILITATION INSTITUTE, LLC

Provider Business Mailing Address
First Line	:	1 ELIZABETH PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45408-1445
Country	:	US
Telephone Number	:	937-424-8200
Fax Number	:	937-424-8250

Provider Business Practice Location Address
First Line	:	1 ELIZABETH PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45408-1445
Country	:	US
Telephone Number	:	937-424-8200
Fax Number	:	937-424-8250

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CRISTINA HUERTA
Credential	:
Telephone Number	:	937-424-8200

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	01/08/2008

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