Provider Demographics
NPI:1023013836
Name:HORNSBY REHABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:HORNSBY REHABILITATION SERVICES LLC
Other - Org Name:FYZICAL THERAPY & BALANCE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-870-7090
Mailing Address - Street 1:9070 W CHEYENNE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8935
Mailing Address - Country:US
Mailing Address - Phone:702-818-5000
Mailing Address - Fax:702-818-5001
Practice Address - Street 1:235 JIM BERRY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-8660
Practice Address - Country:US
Practice Address - Phone:828-369-7878
Practice Address - Fax:828-369-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 261QP2000X
NC3507, 7217, 8721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0796HOtherBCBS
NC7211277Medicaid
NCCF8693OtherRR MEDICARE
NCCF8693OtherRR MEDICARE
NC2502748Medicare ID - Type Unspecified