Provider Demographics
NPI:1669277307
Name:EXALT HEALTH REHABILITATION HOSPITAL WILDWOOD LLC
Entity type:Organization
Organization Name:EXALT HEALTH REHABILITATION HOSPITAL WILDWOOD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DEARDORFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-213-8372
Mailing Address - Street 1:2306 GUTHRIE RD STE 180
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-5952
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4756 COUNTY ROAD 44A
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-7925
Practice Address - Country:US
Practice Address - Phone:214-213-8372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital