Contract Details
Ancillary Care Services
Facility name
RehabTech
Provider ID
P000006123
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
568 North Indiana Avenue
Crown Point, IN 46307
United States
County
Lake
Phone
2196630560 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address