Provider Demographics
NPI:1619415841
Name:ENCORE PREAKNESS, INC.
Entity Type:Organization
Organization Name:ENCORE PREAKNESS, INC.
Other - Org Name:SELECT MEDICAL REHABILITATION SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-510-3850
Mailing Address - Street 1:4025 TAMPA RD
Mailing Address - Street 2:SUITE 1106
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3208
Mailing Address - Country:US
Mailing Address - Phone:888-974-7878
Mailing Address - Fax:727-726-1825
Practice Address - Street 1:7 E CONGRESS ST
Practice Address - Street 2:SUITE 404
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-3337
Practice Address - Country:US
Practice Address - Phone:912-200-9431
Practice Address - Fax:844-273-8748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty