Active NPI
MBRH LLC
Doing business as Mobile Bay Rehabilitation Hospital
- Rehabilitation Hospital
- Daphne, AL
National Provider Identifier
1679857585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Hospital
- License
- H0204
- Legal business name
- MBRH LLC
- Doing business as
- Mobile Bay Rehabilitation Hospital
- Practice address
- 101 Villa Dr
Daphne, AL 36526-4653 - Phone
- (251) 621-4354
- Fax
- (251) 621-4331
- NPI assigned
- Oct 11, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Arnold Heinemann
- Title
- President&Treasurer, SE Healthcare
- Phone
- (845) 746-5004
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital | 283X00000X | H0204 | AL | Primary |
Addresses
Primary practice location
101 Villa Dr
Daphne, AL 36526-4653
Mailing address
101 Villa Dr
Daphne, AL 36526-4653
Phone (251) 621-4354
Other names 1
- Mobile Bay Rehabilitation Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Hospital certification: CCN 013027
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- MOBILE BAY REHABILITATION HOSPITAL
- Certification status
- Terminated Voluntary: merger or closure, Dec 31, 2014
- Provider type (POS)
- Hospital – Rehabilitation
- Participating since
- Nov 18, 1986
- Last certification
- Oct 12, 2000
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- Dec 1, 2011 (1 total)
- Facility address
- 101 Villa Drive
Daphne, AL 36526
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1352073600000",
"number": "1679857585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 VILLA DR",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365264653",
"telephone_number": "251-621-4354",
"fax_number": "251-621-4331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 VILLA DR",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365264653",
"telephone_number": "251-621-4354",
"fax_number": "251-621-4331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MBRH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-11",
"last_updated": "2012-11-05",
"status": "A",
"authorized_official_last_name": "HEINEMANN",
"authorized_official_first_name": "ARNOLD",
"authorized_official_title_or_position": "PRESIDENT&TREASURER, SE HEALTHCARE",
"authorized_official_telephone_number": "845-746-5004",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "283X00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Hospital",
"state": "AL",
"license": "H0204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mobile Bay Rehabilitation Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Daphne, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.