Organization
RIM COUNTRY REHABILITATION, INC.
Active
Other names
Rim Country Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL GODDARD (ADMINISTRATOR)
(928) 474-1120
Entity
Organization
Contact information
Practice address
807 W LONGHORN RD, PAYSON, AZ 85541-4263
(928) 474-1120
(928) 474-0505
Mailing address
807 W LONGHORN RD, PAYSON, AZ 85541-4263
(928) 474-1120
(928) 474-0505
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OTC 4934
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341077
—
AZ
Enumeration date
08/29/2011
Last updated
08/29/2011
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