Provider Demographics
NPI:1083482475
Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF JOHNSTON, LLC
Entity Type:Organization
Organization Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF JOHNSTON, LLC
Other - Org Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF JOHNSTON
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 1:2109 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3246
Mailing Address - Country:US
Mailing Address - Phone:401-587-1000
Mailing Address - Fax:401-587-1395
Practice Address - Street 1:2109 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3246
Practice Address - Country:US
Practice Address - Phone:401-587-1000
Practice Address - Fax:410-587-1395
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital