| Organization Name: | FOUR SEASONS REHAB, INC. |
| NPI Number: | 1164527628 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICTORIA BOURNE (PRESIDENT) |
| Mailing Address: | 108 1/2 Spruce St Bluefield |
| State: | VA US |
| Postal Code: | 246051738 |
| Phone Number: | 2763225511 |
| Fax Number: | 2763222525 |
| NPI Enumeration Date: | 09/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0700X |
| License Number: | 2202001125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Hearing and Speech |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |