Provider Demographics
NPI:1104043694
Name:BEAVER COUNTY REHABILITATION CENTER
Entity Type:Organization
Organization Name:BEAVER COUNTY REHABILITATION CENTER
Other - Org Name:AURORA REHABILITATION
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-847-1306
Mailing Address - Street 1:1517 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15066-2219
Mailing Address - Country:US
Mailing Address - Phone:724-847-1306
Mailing Address - Fax:724-847-1126
Practice Address - Street 1:401 7TH ST
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:PA
Practice Address - Zip Code:15066-1842
Practice Address - Country:US
Practice Address - Phone:724-847-1306
Practice Address - Fax:724-847-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA471560251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services