Provider Demographics
NPI:1861818809
Name:WARM SPRINGS REHABILITATION HOSPITAL OF KYLE, LLC
Entity Type:Organization
Organization Name:WARM SPRINGS REHABILITATION HOSPITAL OF KYLE, LLC
Other - Org Name:WARM SPRINGS REHABILITATION HOSPITAL OF KYLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MISITANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-731-9660
Mailing Address - Street 1:1828 GOOD HOPE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1233
Mailing Address - Country:US
Mailing Address - Phone:717-731-9660
Mailing Address - Fax:
Practice Address - Street 1:5980 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2400
Practice Address - Country:US
Practice Address - Phone:512-262-0821
Practice Address - Fax:512-262-0830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100261283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347731701Medicaid
TX347731701Medicaid