| Organization Name: | SERC REHABILITATION PARTNERS LLC |
| NPI Number: | 1003209701 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN JOHANNESON (VP REVENUE CYCLE OPERATIONS) |
| Mailing Address: | 1225 S 7 Hwy Blue Springs |
| State: | MO US |
| Postal Code: | 640143539 |
| Phone Number: | 8162952051 |
| Fax Number: | 8164632014 |
| NPI Enumeration Date: | 03/05/2015 |
| NPI Last Update Date: | 03/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |