Provider Demographics
NPI:1407360738
Name:ENDURACARE ACUTE CARE SERVICES LLC
Entity Type:Organization
Organization Name:ENDURACARE ACUTE CARE SERVICES LLC
Other - Org Name:ENDURACARE ACUTE CARE SERVICES JACKSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF HUMAN RESOURCES
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:C
Authorized Official - Last Name:BERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-861-8755
Mailing Address - Street 1:381 RIVERSIDE DR STE 440
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-8934
Mailing Address - Country:US
Mailing Address - Phone:615-861-8755
Mailing Address - Fax:615-472-1936
Practice Address - Street 1:1054 GREYMONT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2718
Practice Address - Country:US
Practice Address - Phone:601-955-9624
Practice Address - Fax:601-353-6151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy