MEDICARE: ROCKWALL REHAB HOSPITALS, LTD

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	008504	TX

General Provider Information

NPI Number	:	1831330984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKWALL REHAB HOSPITALS, LTD

Provider Business Mailing Address
First Line	:	2301 MARSH LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8497
Country	:	US
Telephone Number	:	972-428-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 MARSH LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8497
Country	:	US
Telephone Number	:	972-428-1600
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARK KENNEDY
Credential	:
Telephone Number	:	972-479-1380

Provider Enumeration Date	:	03/19/2009
Last Update Date	:	04/24/2009

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