Provider Demographics
NPI:1043760739
Name:JOINT VENTURES REHABILITATION LLC
Entity Type:Organization
Organization Name:JOINT VENTURES REHABILITATION LLC
Other - Org Name:HEALTHSOURCE OF SICKLERVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-782-2077
Mailing Address - Street 1:817 ERIAL NEW BROOKLYN RD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-3278
Mailing Address - Country:US
Mailing Address - Phone:856-782-2077
Mailing Address - Fax:856-782-2078
Practice Address - Street 1:817 ERIAL NEW BROOKLYN RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-3278
Practice Address - Country:US
Practice Address - Phone:856-782-2077
Practice Address - Fax:856-782-2078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00693600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty