St George Rehabilitation Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

05004004A Issued in IN

Legal business name

ST GEORGE REHABILITATION SERVICES LLC

Practice address

11628 Ventura Dr
Saint John, IN 46373-9458

Phone

(219) 365-4561

NPI assigned

Aug 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William M Elgendi, RPT

Title

Sole MBR

Phone

(219) 365-4561

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1306078290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11628 VENTURA DR",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739458",
            "telephone_number": "219-365-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11628 VENTURA DR",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739458",
            "telephone_number": "219-365-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GEORGE REHABILITATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "ELGENDI",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "219-365-4561",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "05004004A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• St. John Premier Dental
• Katherine Stalbaum, MD

• Home Health Agency in Saint John, IN
• Providers in Saint John, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.