| NPI | 1104239763 | 
|---|---|
| Former Legal Business Name | SOUTHLAKE REHAB LLC | 
| Entity Type | Organization | 
| Authorized Contact | RANI KRIPLANI PT 219-525-4815 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist | 
| Additional Taxonomies | 251E00000X Home Health | 
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2014-06-11 | 
| Last Update Date | 2019-09-09 |