Provider Demographics
NPI:1538107222
Name:ENHANCE REHABILITATION, INC.
Entity Type:Organization
Organization Name:ENHANCE REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:314-503-6148
Mailing Address - Street 1:753 GODDARD AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1106
Mailing Address - Country:US
Mailing Address - Phone:636-536-1020
Mailing Address - Fax:636-536-0864
Practice Address - Street 1:4431 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-1258
Practice Address - Country:US
Practice Address - Phone:314-481-4840
Practice Address - Fax:314-481-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO266614Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER