SUNDANCE REHABILITATION AGENCY INC NPI 1407012990

NPI Information

NPI: 1407012990
Provider Name: SUNDANCE REHABILITATION AGENCY, INC

Doing Business As: SUNDANCE REHABILITATION AGENCY OF MISSOURI

Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
14525 CLAYTON RD
APT #410
BALLWIN, MO
ZIP 63011
Phone: (636) 527-3510
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SUNDANCE REHABILITATION AGENCY, INC is a rehabilitation clinic center in Ballwin, MO. SUNDANCE REHABILITATION AGENCY, INC NPI is 1407012990. The provider is registered as an organization entity type.
The provider Is Doing Business As Sundance Rehabilitation Agency Of Missouri.

The provider's business location address is:

14525 CLAYTON RD
APT #410
BALLWIN, MO
ZIP 63011-764
Phone: (636) 527-3510
Fax: (636) 527-3510

The provider's authorized official is Sue Gwyn .
The authorized official title is President Director and has the following contact phone number (505) 821-3355.

The enumeration date for this NPI number is 8/4/2008 and was last updated on 9/30/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation		MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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