Provider Demographics
NPI:1508104688
Name:COMPLEX REHAB SOLUTIONS, LLC
Entity Type:Organization
Organization Name:COMPLEX REHAB SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:828-238-2130
Mailing Address - Street 1:431 9TH ST NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3523
Mailing Address - Country:US
Mailing Address - Phone:828-238-2130
Mailing Address - Fax:
Practice Address - Street 1:431 9TH ST NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3523
Practice Address - Country:US
Practice Address - Phone:828-238-2130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2547251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health