Basic Information
| Provider Information | |||||||||
| NPI: | 1558810614 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEARTLAND REHABILITATION SERVICES OF KENTUCKY, LLC | ||||||||
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| OtherOrganizationName: | HEARTLAND REHABILITATION SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 N SUMMIT ST | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436042615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192525500 | ||||||||
| FaxNumber: | 8773859446 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MUNFORDVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427659435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707864551 | ||||||||
| FaxNumber: | 2707864551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2016 | ||||||||
| LastUpdateDate: | 09/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | ALLEN | ||||||||
| AuthorizedOfficialFirstName: | MARTIN | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4192525734 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | IN PROGRESS | KY | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.