Organization
FAITH REHAB HEALTHCARE, INC.
Active
Organization
FAITH REHAB HEALTHCARE, INC.
Active
Other names
NA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FATIMA L LAQUINDANUM PT (ADMINISTRATOR)
(901) 725-2000
Entity
Organization
Contact information
Practice address
1750 MADISON AVE, SUITE 120, MEMPHIS, TN 38104-6492
(901) 725-2000
(901) 725-2002
Mailing address
1750 MADISON AVE, SUITE 120, MEMPHIS, TN 38104-6492
(901) 725-2000
(901) 725-2002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 103140
MO
225100000X
Physical Therapist
Primary
PT 5144
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3731466
—
TN
01
—
4115744
BCBS GROUP NUMBER
TN
01
—
DE5742
MEDICARE RAILROAD NUMBER
TN
Enumeration date
07/06/2006
Last updated
08/22/2020
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