Organization
SAGAMORE REHABILITATION CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA E HAWORTH PT (PRESIDENT)
(765) 409-9006
Entity
Organization
Contact information
Practice address
127 N MAIN ST, MONTICELLO, IN 47960-2130
(574) 808-3165
(574) 808-3166
Mailing address
127 N MAIN ST, MONTICELLO, IN 47960-2130
(574) 808-3165
(574) 808-3166
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200109430A
—
IN
Enumeration date
12/13/2006
Last updated
11/11/2013
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