Provider Demographics
NPI:1366416208
Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NORTHWEST TUCSON, L.P.
Entity type:Organization
Organization Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NORTHWEST TUCSON, L.P.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:BENNETT
Authorized Official - Last Name:MCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-970-3442
Mailing Address - Street 1:1921 W HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7806
Mailing Address - Country:US
Mailing Address - Phone:520-742-2800
Mailing Address - Fax:520-544-5398
Practice Address - Street 1:1921 W HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-742-2800
Practice Address - Fax:520-742-2639
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-15
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSH-187283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ033029OtherPTAN
5000071OtherUNITED HEALTHCARE
AZ0292580OtherBLUE CROSS
AZ0142370OtherBLUE CROSS
3102187OtherDEPT OF LABOR
120301400OtherDEPT OF TREASURY
AZ0104365Medicaid
IZ0116OtherHEALTHNET
IZ0116OtherHEALTHNET
AZ0292580OtherBLUE CROSS
AZ0104365Medicaid