# SERC REHABILITATION PARTNERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SERC - Grain Valley
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013311257
- **Authorized official:** KEVIN JOHANNESON (VP REVENUE CYCLE OPERATIONS)
- **Authorized official phone:** (423) 238-7217

## Contact information

- **Practice address:** 103 SW EAGLES PKWY, GRAIN VALLEY, MO 64029-8512
- **Practice address phone:** (816) 443-2375
- **Practice address fax:** (816) 443-2380
- **Mailing address:** 8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
- **Mailing address phone:** (423) 238-7217
- **Mailing address fax:** (423) 238-3473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/17/2014
- **Last updated:** 10/17/2014