Provider Demographics
NPI:1194046508
Name:21ST CENTURY REHABILITATION SERVICES
Entity type:Organization
Organization Name:21ST CENTURY REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:HUTCHINS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, CBIST, CCM
Authorized Official - Phone:615-452-9766
Mailing Address - Street 1:575 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-4901
Mailing Address - Country:US
Mailing Address - Phone:615-452-9766
Mailing Address - Fax:615-452-1125
Practice Address - Street 1:575 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-4901
Practice Address - Country:US
Practice Address - Phone:615-452-9766
Practice Address - Fax:615-452-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN444535Medicare UPIN