# PHOENIX REHAB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760748248
- **Authorized official:** MR. LARRY CAIN (OWNER)
- **Authorized official phone:** (918) 585-5109

## Contact information

- **Practice address:** 1021 CHARLES PAGE BLVD, STE 200, TULSA, OK 74127-8815
- **Practice address phone:** (918) 585-5109
- **Practice address fax:** (918) 743-3767
- **Mailing address:** 1021 CHARLES PAGE BLVD, STE 200, TULSA, OK 74127
- **Mailing address phone:** (918) 585-5109
- **Mailing address fax:** (918) 743-3767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 04/09/2012
- **Last updated:** 04/09/2012