Contract Details
Ancillary Care Services
Facility name
TLC Rehab
Provider ID
P000005462
NPI
1841267952
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
5612 Southeast Absnier Boulevard Suite 2
Belleview, FL 34420
United States
County
Marion
Phone
3523070066 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address