Provider Demographics
NPI:1922332048
Name:REHAB CARE
Entity Type:Organization
Organization Name:REHAB CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:MONTES-KOLENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC
Authorized Official - Phone:618-580-8811
Mailing Address - Street 1:1213 SHENANDOAH AVE
Mailing Address - Street 2:APT C
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-4167
Mailing Address - Country:US
Mailing Address - Phone:618-580-8811
Mailing Address - Fax:
Practice Address - Street 1:7601 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5001
Practice Address - Country:US
Practice Address - Phone:314-961-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009021161314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility