Provider Demographics
NPI:1881641058
Name:DENTON REHABILITATION HOSPITAL LP
Entity Type:Organization
Organization Name:DENTON REHABILITATION HOSPITAL LP
Other - Org Name:MAYHILL HOPSITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-239-3000
Mailing Address - Street 1:2809 S MAYHILL RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5910
Mailing Address - Country:US
Mailing Address - Phone:940-239-3000
Mailing Address - Fax:940-239-3090
Practice Address - Street 1:2809 S MAYHILL RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-5910
Practice Address - Country:US
Practice Address - Phone:940-239-3000
Practice Address - Fax:940-239-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008317284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182861802Medicaid
TX670010Medicare ID - Type Unspecified