Organization
REBUILD REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK JERMAAL GREENE OTR/L (OWNER/ADMINISTRATOR)
(562) 508-0429
Entity
Organization
Contact information
Practice address
10143 BRUSSELS LN, CORDOVA, TN 38016-0572
(562) 508-0429
Mailing address
10143 BRUSSELS LN, CORDOVA, TN 38016-0572
(562) 508-0429
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
4021
TN
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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