Provider Demographics
NPI:1528007440
Name:REHABTRUST, INC
Entity Type:Organization
Organization Name:REHABTRUST, INC
Other - Org Name:ADVANCED REHABTRUST HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-384-0393
Mailing Address - Street 1:2433 FORT WORTH DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7684
Mailing Address - Country:US
Mailing Address - Phone:940-384-0393
Mailing Address - Fax:940-384-0003
Practice Address - Street 1:2433 FORT WORTH DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7684
Practice Address - Country:US
Practice Address - Phone:940-384-0393
Practice Address - Fax:940-384-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007973251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158360101Medicaid
TX158360101Medicaid