Basic Information
| Provider Information | |||||||||
| NPI: | 1073502837 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GATEWAY AT FLORENCE REHABILITATION HOSPITAL, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GATEWAY REHABILITATION HOSPITAL AT FLORENCE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5940 MERCHANT DR | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410421158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8594262400 | ||||||||
| FaxNumber: | 8594262419 | ||||||||
| Practice Location | |||||||||
| Address1: | 5940 MERCHANT DR | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410421158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8594262400 | ||||||||
| FaxNumber: | 8594262419 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2005 | ||||||||
| LastUpdateDate: | 07/09/2014 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BILLIG | ||||||||
| AuthorizedOfficialFirstName: | SAMANTHA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHEIF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8594262400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | 100928 | KY | Y | Hospitals | Rehabilitation Hospital |
No ID Information.