Basic Information
| Provider Information | |||||||||
| NPI: | 1750332482 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REHABCARE GROUP OF MIDLAND, LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7733 FORSYTH BLVD | ||||||||
| Address2: | SUITE 2300 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631051817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006771202 | ||||||||
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| Practice Location | |||||||||
| Address1: | 207 TRADEWINDS BLVD | ||||||||
| Address2: | |||||||||
| City: | MIDLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797062807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4325201401 | ||||||||
| FaxNumber: | 4325291215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 05/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | SHORT | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3146592173 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | PENDING | Y | Hospitals | Rehabilitation Hospital |
ID Information
| ID | Type | State | Issuer | Description | 183421001 | 05 | TX | MEDICAID |