Contract Details
Elite Rehab, Inc.
Facility name
Elite Rehab, Inc.
Provider ID
P000008680
NPI
1518361294
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
935 US Highway 431 Suite 1
Roanoke, AL 36274
United States
County
Randolph
Phone
3348632068 (Phone)
Billing Details
Address
1636 Mulberry St.
Montgomery, AL 36106
Billing Phone
3342653199
Specialty Type
Physical Therapy
Map
Address