Provider Demographics
NPI:1376114827
Name:SELECT REHABILITATION
Entity Type:Organization
Organization Name:SELECT REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MOFFIT
Authorized Official - Suffix:
Authorized Official - Credentials:OTA
Authorized Official - Phone:859-267-0166
Mailing Address - Street 1:145 SAINT FRANCIS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:KY
Mailing Address - Zip Code:40062-7013
Mailing Address - Country:US
Mailing Address - Phone:859-267-0166
Mailing Address - Fax:
Practice Address - Street 1:1155 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1401
Practice Address - Country:US
Practice Address - Phone:502-636-5241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility