Basic Information
| Provider Information | |||||||||
| NPI: | 1639137128 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EFFINGHAM REHAB SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 SHAWNEE RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458053529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1419221671 | ||||||||
| FaxNumber: | 9128269767 | ||||||||
| Practice Location | |||||||||
| Address1: | 804 TOWNE PARK DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | RINCON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9128263797 | ||||||||
| FaxNumber: | 9128269767 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 12/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | ROUSH | ||||||||
| AuthorizedOfficialFirstName: | BRAD | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4192216712 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.