Contract Details
Ancillary Care Services
Facility name
TLC Rehab
Provider ID
P000003904
NPI
1144299710
Tax ID
650443469
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
150 Southeast 17th Street Suite 301
Ocala, FL 34471
United States
County
Marion
Phone
3528675500 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address