Provider Demographics
NPI:1982628525
Name:REHAB ENTERPRISES,LLC
Entity Type:Organization
Organization Name:REHAB ENTERPRISES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ODILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-766-9819
Mailing Address - Street 1:1097 INDIAN GROVE LN
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-7669
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1097 INDIAN GROVE LN
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-7669
Practice Address - Country:US
Practice Address - Phone:417-766-9819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO114485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODG2952OtherRAILROAD MEDICARE PIN
MO=========OtherBCBS PIN