Basic Information
| Provider Information | |||||||||
| NPI: | 1891727475 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RHSC EL PASO, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SIERRA PROVIDENCE PHYSICAL REHABILITATION HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 849994 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752840001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155778358 | ||||||||
| FaxNumber: | 9155417714 | ||||||||
| Practice Location | |||||||||
| Address1: | 1740 CURIE DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799022901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155443399 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 03/24/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MORGAN | ||||||||
| AuthorizedOfficialFirstName: | JESSICA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9158322700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | 000638 | TX | Y | Hospitals | Rehabilitation Hospital |
ID Information
| ID | Type | State | Issuer | Description | 0211708-01 | 05 | TX | MEDICAID | HH0841 | 01 | BCBS OF TEXAS | OTHER | 453033B000000 | 01 | SECTION 1011 | OTHER | 076538190 | 01 | AETNA US HEALTHCARE | OTHER |