Provider Demographics
NPI:1922321447
Name:REHABILITATION HOSPITAL OF MESQUITE LLC
Entity Type:Organization
Organization Name:REHABILITATION HOSPITAL OF MESQUITE LLC
Other - Org Name:MESQUITE REHABILITATION INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-216-2299
Mailing Address - Street 1:1024 N GALLOWAY AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-2434
Mailing Address - Country:US
Mailing Address - Phone:972-216-2299
Mailing Address - Fax:
Practice Address - Street 1:1023 N BELTLINE RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-2434
Practice Address - Country:US
Practice Address - Phone:972-216-2400
Practice Address - Fax:972-216-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100067OtherHOSPITAL LICENSE
TX2188682-01Medicaid