Provider Demographics
NPI:1730165739
Name:REHABCARE GROUP EAST LLC
Entity type:Organization
Organization Name:REHABCARE GROUP EAST LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:439 S KIRKWOOD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6100
Mailing Address - Country:US
Mailing Address - Phone:314-822-6297
Mailing Address - Fax:314-822-6298
Practice Address - Street 1:439 S KIRKWOOD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122
Practice Address - Country:US
Practice Address - Phone:314-822-6297
Practice Address - Fax:314-822-6298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO266554Medicare Oscar/Certification
MO266554Medicare Oscar/Certification