Organization
TRI-VISTA REHAB, INC
Active
Parent organization
TRI-VISTA REHAB, INC
Other names
TriVista Rehab at Community Development Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-VISTA REHAB, INC
Authorized official
KEVIN BOUTIN OTR (PRESIDENT)
(662) 840-0535
Entity
Organization
Contact information
Practice address
411 OAK ST., RICHTON, MS 39476
(662) 270-6486
(662) 842-7915
Mailing address
PO BOX 3592, TUPELO, MS 38803-3592
(662) 840-0535
(662) 842-7915
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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