Deanna  L  Foster    RPT
Contract Details
Encore Rehab of Mobile-Tillman's Corner
Facility name
Provider ID
P000000560
NPI
1902825599
Tax ID
631225408
Effective Date
8/11/2000
Last Updated
5/9/2013
Direct Contract
Yes
Term Date
5/9/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
5420 Highway 90 West
Mobile, AL 36619
United States
County
Mobile
Phone
2516601505 (Phone)
Billing Details
Address
1908 Flint Road Southeast
Decatur, AL 35601
Billing Phone
2563409708
Specialty Type
Physical Therapy
Map
Address