Contract Details
Facility name
Elite Rehab
Provider ID
P000000001
NPI
1518361294
Tax ID
471891674
Effective Date
9/7/2023
Last Updated
9/14/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
11123 Chantilly Parkway Circle Suite D
Pike Road, AL 36064
United States
Phone
334-746-5522 (Phone)
Billing Details
Address
11123 Chantilly Parkway Circle
Suite D
Pike Road, AL 36064
Billing Phone
334-746-5522
Specialty Type
Physical Therapy
Website
Visit Website
Map
Address