Organization
REHABCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. POONAM BAJAJ OTR (PROGRAM DIRECTOR)
(913) 631-9108
Entity
Organization
Contact information
Practice address
8101 MISSION RD, PRAIRIE VILLAGE, KS 66208-5238
(913) 385-5021
(913) 385-5021
Mailing address
12510 W 62ND TER STE 107, SHAWNEE, KS 66216-1869
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1702106
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37636011
BCBS PROVIDER NUMBER
KS
Enumeration date
04/09/2007
Last updated
08/22/2020
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