Provider Demographics
NPI:1083714505
Name:NATIONAL REHABILITATION CARE
Entity Type:Organization
Organization Name:NATIONAL REHABILITATION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTAWEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-492-6197
Mailing Address - Street 1:5029 BACKLICK RD # A
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-6044
Mailing Address - Country:US
Mailing Address - Phone:260-492-6197
Mailing Address - Fax:
Practice Address - Street 1:6642 SAINT JOE RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46835-1933
Practice Address - Country:US
Practice Address - Phone:260-492-6197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004444A261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy