Provider Demographics
NPI:1366512006
Name:AUSTIN REHAB SERVICES
Entity type:Organization
Organization Name:AUSTIN REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-429-3003
Mailing Address - Street 1:720A S DUNCAN BYP
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-7830
Mailing Address - Country:US
Mailing Address - Phone:864-429-3003
Mailing Address - Fax:864-429-3095
Practice Address - Street 1:720A S DUNCAN BYP
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-7830
Practice Address - Country:US
Practice Address - Phone:864-429-3003
Practice Address - Fax:864-429-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QP2000X261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3003Medicaid
SCGP3003Medicaid