Contract Details
Facility name
Elite Rehab
Provider ID
P000000001
NPI
861539913
Tax ID
471891674
Effective Date
9/7/2023
Last Updated
3/5/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
102 Medical Center Drive Suite G
Prattville, AL 36066
United States
Phone
334-239-0708 (Phone)
Billing Details
Address
935 Highway 431
Suite 1
Roanoke, AL 36274
Billing Phone
334-239-0708
Specialty Type
Physical Therapy
Map
Address