Provider Demographics
NPI:1093901472
Name:REHABCARE
Entity Type:Organization
Organization Name:REHABCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:816-478-3141
Mailing Address - Street 1:4304 S JAMES AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4731
Mailing Address - Country:US
Mailing Address - Phone:816-478-3141
Mailing Address - Fax:816-478-3141
Practice Address - Street 1:4304 S JAMES AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4731
Practice Address - Country:US
Practice Address - Phone:816-478-3141
Practice Address - Fax:816-478-3141
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHABCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000137282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital