Contract Details
Ancillary Care Services
Facility name
TLC Rehab
Provider ID
P000004235
NPI
1306168463
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
5918 North Davis Highway
Pensacola, FL 32503
United States
County
Escambia
Phone
3523824800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address