Southport Rehab Associates, Inc

LBN: Southport Rehab Associates, Inc
Southport Rehab Associates, Inc is an health care organization with primary practice located at 7201 Green Bay Rd , Kenosha WI 53142-3522. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, which is considered as the primary health care specialty. Southport Rehab Associates, Inc can be contacted via phone (262) 694-3977, or through Letsom, William H via phone (262) 694-3977.

Contact Information

Primary practice address
7201 Green Bay Rd Kenosha WI 53142-3522
Phone: (262) 694-3977
Fax: (262) 694-5648
Website:
Map and Directions
Authorized official contact:
Name: Letsom, William H Physical Therapist (PT)
Phone: (262) 694-3977

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X Wisconsin

Profile Details

NPI number 1114929064
LBN Legal business name Southport Rehab Associates, Inc
DBA Doing business as
Authorized official Letsom, William H Physical Therapist (PT)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 11th, 2005
Last updated Apr 10th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114929064 NPPES
Wisconsin MEDICAID 41695100
Wisconsin MEDICAID 41811000

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