Provider Demographics
NPI:1043229560
Name:SOUTHWEST REGIONAL REHABILITATION CENTER
Entity Type:Organization
Organization Name:SOUTHWEST REGIONAL REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-965-3206
Mailing Address - Street 1:393 E ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017
Mailing Address - Country:US
Mailing Address - Phone:269-965-3206
Mailing Address - Fax:269-441-4141
Practice Address - Street 1:393 ROOSEVELT AVE E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3333
Practice Address - Country:US
Practice Address - Phone:269-965-3206
Practice Address - Fax:269-441-4147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1556779Medicaid
MI00250OtherBLUE CROSS
MI3511696Medicaid
MI5172124Medicaid
MI1556779Medicaid