Provider Demographics
NPI:1164496006
Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF COLORADO SPRINGS, INC.
Entity Type:Organization
Organization Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF COLORADO SPRINGS, INC.
Other - Org Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF COLORADO SPRINGS
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 1:325 S PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910
Practice Address - Country:US
Practice Address - Phone:719-630-8000
Practice Address - Fax:719-520-0387
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-15
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0261283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
00791HEOtherBLUE CROSS
AR0500211Medicaid
00791HEOtherBLUE CROSS