Provider Demographics
| NPI: | 1316574569 |
|---|---|
| Name: | BHSM REHABILITATION, LLC |
| Entity type: | Organization |
| Organization Name: | BHSM REHABILITATION, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VICE PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MICHAEL |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | TARVIN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 717-972-1100 |
| Mailing Address - Street 1: | 4714 GETTYSBURG RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MECHANICSBURG |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 17055-4325 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 885 E WARNER RD |
| Practice Address - Street 2: | |
| Practice Address - City: | GILBERT |
| Practice Address - State: | AZ |
| Practice Address - Zip Code: | 85296-3075 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 717-972-1100 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | SELECT MEDICAL |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2020-03-26 |
| Last Update Date: | 2023-05-02 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
| No | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |