Basic Information
| Provider Information | |||||||||
| NPI: | 1609285790 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | 21ST CENTURY REHAB, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | WEBSTER CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 505956600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5158327735 | ||||||||
| FaxNumber: | 5158327795 | ||||||||
| Practice Location | |||||||||
| Address1: | 1231 S G AVE | ||||||||
| Address2: | |||||||||
| City: | NEVADA | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502012717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153823366 | ||||||||
| FaxNumber: | 5153821576 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2014 | ||||||||
| LastUpdateDate: | 08/04/2014 | ||||||||
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| AuthorizedOfficialLastName: | SKAGGS | ||||||||
| AuthorizedOfficialFirstName: | CHRISTA | ||||||||
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| AuthorizedOfficialTitleorPosition: | HUMAN RESOURCES DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5153823366 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | 073706 | IA | Y | Hospitals | Rehabilitation Hospital |
No ID Information.