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Contract Details
Encore Rehabilitation, Inc.
Facility name
Encore Rehab of Oak Grove
Provider ID
P000008736
Tax ID
631225408
Effective Date
1/1/1997
Last Updated
7/18/2019
Direct Contract
Yes
Term Date
6/17/2019
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
5266 Old Hwy 11 Suite 130
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
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Address