Organization
ENCORE REHABILITATION INC
Active
Other names
Encore Rehab of Lucedale
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL G HENDERSON PT (PRESIDENT)
(256) 350-1764
Entity
Organization
Contact information
Practice address
2210 MILL STREET EXT # B, LUCEDALE, MS 39452-6064
(601) 947-9005
(601) 947-9007
Mailing address
PO BOX 8419, BILOXI, MS 39535-8087
(228) 388-5714
(228) 388-0017
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090-15077
—
MS
01
—
1033218524
GROUP NPI
MS
01
—
256-545
MEDICARE PART A
MS
Enumeration date
02/23/2007
Last updated
12/02/2020
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