Contract Details
Elite Rehab, Inc.
Facility name
Elite Rehab, Inc.
Provider ID
P000008679
NPI
1588020606
Tax ID
471891674
Effective Date
4/12/2017
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
1636 Mulberry Street
Montgomery, AL 36106
United States
County
Montgomery
Phone
3342653199 (Phone)
Billing Details
Address
1636 Mulberry Street
Montgomery, AL 36106
Billing Phone
3342653199
Specialty Type
Physical Therapy
Map
Address