Organization · Type 2 NPI

Tri-Vista Rehab, Inc

Rehabilitation Clinic/Center · Richton, MS

NPI number 1265025522 Active

Practice location

411 Oak St.
Richton, MS 39476

Call (662) 270-6486 Map

Fax (662) 842-7915

Mailing address

PO Box 3592
Tupelo, MS 38803-3592

Specialties and licenses

Taxonomy	Code	License
Rehabilitation Clinic/Center Primary	261QR0400X	None listed

Rehabilitation Clinic/Center: Definition to come...

NPI record

NPI: 1265025522
Entity type: Organization (Type 2)
Issued: Feb 18, 2021
Last updated: Feb 18, 2021
Status: Active
Subpart: Yes of Tri-Vista Rehab, Inc

Other names

Trivista Rehab at Community Development Inc. · doing business as

Authorized official

Kevin Boutin, OTR
President
(662) 840-0535

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1265025522

Tri-Vista Rehab, Inc's National Provider Identifier is 1265025522, issued on Feb 18, 2021. The primary taxonomy on file is Rehabilitation Clinic/Center (261QR0400X), and the practice location is in Richton, MS. The record was last updated on Feb 18, 2021.