Provider Demographics
NPI:1598095440
Name:REHAB CARE
Entity Type:Organization
Organization Name:REHAB CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HEPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:303-989-3611
Mailing Address - Street 1:7932 S VALENTIA ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3302
Mailing Address - Country:US
Mailing Address - Phone:303-993-3567
Mailing Address - Fax:
Practice Address - Street 1:7733 FORSYTH BLVD STE 2300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1806
Practice Address - Country:US
Practice Address - Phone:303-989-3118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-27
Last Update Date:2009-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14006529310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility