Provider Demographics
NPI:1205679164
Name:REHAB MANAGED CARE OF ARIZONA, INC
Entity type:Organization
Organization Name:REHAB MANAGED CARE OF ARIZONA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF REVENUE CYCLE MGT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-789-8115
Mailing Address - Street 1:14090 SOUTHWEST FWY STE 101
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3678
Mailing Address - Country:US
Mailing Address - Phone:916-789-8115
Mailing Address - Fax:916-773-1481
Practice Address - Street 1:2801 OSLER DR STE 122
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1059
Practice Address - Country:US
Practice Address - Phone:469-515-8150
Practice Address - Fax:469-225-9964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy