Contract Details
Encore Rehabilitation, Inc.
Facility name
Encore Rehab of Petal
Provider ID
P000008729
NPI
1548396807
Tax ID
631225408
Effective Date
9/1/2019
Last Updated
9/12/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
100 Eastbrookw Drive Suite 130
Petal, MS 39465
United States
County
Forrest
Phone
6015440500 (Phone)
Billing Details
Address
251 Johnston Street SE
3rd Floor
Decatur, AL 35601
Billing Phone
2563409708
Specialty Type
Physical Therapy
Map
Address