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Contract Details
Genesis Health
Facility name
Brooks Rehab Center
Provider ID
P000000001
NPI
1225619919
Tax ID
592249372
Effective Date
2/13/2020
Last Updated
7/29/2022
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_440
Exhibit Attachment
Location Details
Address
2621 Enterprise Road Suite 100
Orange City, FL 32763
United States
Phone
386-775-7488
(
Phone
)
Fax
386-775-9515
Billing Details
Address
2621 Enterprise Road
Suite 100
Orange City, FL 32763
Billing Phone
386-775-7488
Specialty Type
Physical Therapy
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