Provider Demographics
NPI:1902870132
Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE, LLC
Entity Type:Organization
Organization Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE, LLC
Other - Org Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WISNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-970-5702
Mailing Address - Street 1:9001 LIBERTY PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7509
Mailing Address - Country:US
Mailing Address - Phone:205-967-7116
Mailing Address - Fax:205-969-6650
Practice Address - Street 1:9630 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-551-5400
Practice Address - Fax:480-551-5401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-14
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSH0176283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
026717OtherAZ PHYSICIAN IPA
AZ026717Medicaid
026717OtherINDIAN HEALTH SERVICES
AZ0201920OtherBLUE CROSS
026717OtherHEALTH CHOICE
AZ0298060OtherBLUE CROSS
IZ7228OtherHEALTHNET OF ARIZONA
AZ026717Medicaid