Provider Demographics
NPI:1770799413
Name:COMPLETE REHAB INC
Entity type:Organization
Organization Name:COMPLETE REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RACKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-324-0961
Mailing Address - Street 1:424 S MUSTANG RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7315
Mailing Address - Country:US
Mailing Address - Phone:405-324-0961
Mailing Address - Fax:405-324-0971
Practice Address - Street 1:424 S MUSTANG RD
Practice Address - Street 2:SUITE B
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7315
Practice Address - Country:US
Practice Address - Phone:405-324-0961
Practice Address - Fax:405-324-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2273302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37-6613Medicare ID - Type Unspecified