MEDICARE: RURAL REHABILITATION SERVICES, 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	:	1932853355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RURAL REHABILITATION SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 452
Second Line	:
City	:	WAUNETA
State	:	NE
Zip	:	69045-0452
Country	:	US
Telephone Number	:	308-394-5333
Fax Number	:	308-365-1927

Provider Business Practice Location Address
First Line	:	130 N TECUMSEH
Second Line	:
City	:	WAUNETA
State	:	NE
Zip	:	69045-9726
Country	:	US
Telephone Number	:	308-394-5333
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSIE KERCHAL
Credential	:	M.S. CCC-SLP
Telephone Number	:	308-394-5333

Provider Enumeration Date	:	02/04/2022
Last Update Date	:	02/04/2022

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