Basic Information
| Provider Information | |||||||||
| NPI: | 1710267802 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOT SPRINGS COMPREHENSIVE THERAPY SERVICES LLC | ||||||||
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| OtherOrganizationName: | COMPLEAT REHAB AND SPORTS THERAPY CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2675 COURT DR | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280541478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048247800 | ||||||||
| FaxNumber: | 7048247898 | ||||||||
| Practice Location | |||||||||
| Address1: | 2278 ALBERT PIKE ROAD | ||||||||
| Address2: | STE B | ||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719134157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017670808 | ||||||||
| FaxNumber: | 5017670832 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2011 | ||||||||
| LastUpdateDate: | 02/04/2013 | ||||||||
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| AuthorizedOfficialLastName: | HUMPHRIES | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | T. | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING/CREDENTIAL SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 7048247800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 227800000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | 261QR0401X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.