Provider Demographics
NPI:1801573969
Name:REHABILITATION AND CRITICAL CARE HOSPITAL OF THE BLACK HILLS, LLC
Entity type:Organization
Organization Name:REHABILITATION AND CRITICAL CARE HOSPITAL OF THE BLACK HILLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-745-6533
Mailing Address - Street 1:4600 LENA DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4904
Mailing Address - Country:US
Mailing Address - Phone:559-892-2500
Mailing Address - Fax:
Practice Address - Street 1:2115 PROMISE ROAD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-8981
Practice Address - Country:US
Practice Address - Phone:605-646-6040
Practice Address - Fax:605-646-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273Y00000XHospital UnitsRehabilitation Unit
No282E00000XHospitalsLong Term Care Hospital