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Contract Details
Ancillary Care Services
Facility name
RehabTech
Provider ID
P000006114
Tax ID
364141292
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
317 East Main Street
Griffith, IN 46319
United States
County
Lake
Phone
2199242547
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address