Provider Demographics
NPI:1700101151
Name:PRO STEP REHAB
Entity type:Organization
Organization Name:PRO STEP REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:270-475-4227
Mailing Address - Street 1:75 BUCKNER ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-2749
Mailing Address - Country:US
Mailing Address - Phone:270-933-8281
Mailing Address - Fax:
Practice Address - Street 1:124 W NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:KY
Practice Address - Zip Code:42266-9763
Practice Address - Country:US
Practice Address - Phone:270-475-4227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility