Provider Demographics
NPI:1386955631
Name:BAPTIST MEMORIAL REGIONAL REHABILITATION SERVICES INC
Entity type:Organization
Organization Name:BAPTIST MEMORIAL REGIONAL REHABILITATION SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEROUSSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-757-3439
Mailing Address - Street 1:2100 EXETER RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3966
Mailing Address - Country:US
Mailing Address - Phone:901-757-3439
Mailing Address - Fax:
Practice Address - Street 1:2100 EXETER RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3966
Practice Address - Country:US
Practice Address - Phone:901-757-3439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST MEMORIAL REGIONAL REHABILITATION SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-01
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility