Organization
SUNDANCE REHABILITATION AGENCY, INC
Active
Parent organization
SUNDANCE REHABILITATION CORPORATION
Other names
SunDance Rehabilitation Agency of Missouri
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNDANCE REHABILITATION CORPORATION
Authorized official
SUE GWYN (PRESIDENT DIRECTOR)
(505) 821-3355
Entity
Organization
Contact information
Practice address
14525 CLAYTON RD, APT #410, BALLWIN, MO 63011-2764
(636) 527-3510
(636) 527-3510
Mailing address
101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM 87109-4373
(505) 468-5604
(505) 468-4681
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
MO
Other
Enumeration date
08/04/2008
Last updated
09/30/2009
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