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Contract Details
Ancillary Care Services
Facility name
Grace Rehab
Provider ID
P000005393
NPI
1801808985
Tax ID
710983044
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
901 North McDonald Street Suite 906
McKinney, TX 75069
United States
County
Collin
Phone
9729841851
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address