Contract Details
Encore Rehabilitation, Inc.
Facility name
Encore Rehab of Hattiesburg
Provider ID
P000009368
NPI
1417251414
Tax ID
631225408
Effective Date
6/18/2019
Last Updated
9/12/2019
Direct Contract
Yes
Term Date
8/31/2019
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
122 98 Place Blvd.
Hattiesburg, MS 39402
United States
County
Lamar
Phone
6012680208 (Phone)
Billing Details
Address
251 Johnston Street SE
3rd Floor
Decatur, AL 35601
Billing Phone
2563409708
Specialty Type
Physical Therapy
Map
Address