Provider Demographics
NPI:1558473330
Name:MATHIS REHAB CENTERS LLC
Entity Type:Organization
Organization Name:MATHIS REHAB CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L,CHT
Authorized Official - Phone:785-320-6616
Mailing Address - Street 1:2021 VANESTA PLACE
Mailing Address - Street 2:SUITE D
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-8707
Mailing Address - Country:US
Mailing Address - Phone:785-320-6616
Mailing Address - Fax:
Practice Address - Street 1:1133 COLLEGE AVENUE
Practice Address - Street 2:G200
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-320-6616
Practice Address - Fax:785-320-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
KS17-00445225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty