Provider Demographics
NPI:1114050028
Name:REHAB BUILDERS OF THE CAROLINAS, PLLC
Entity Type:Organization
Organization Name:REHAB BUILDERS OF THE CAROLINAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:704-728-6929
Mailing Address - Street 1:13016 EASTFIELD RD
Mailing Address - Street 2:STE 200-336
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6622
Mailing Address - Country:US
Mailing Address - Phone:704-274-9062
Mailing Address - Fax:866-268-3797
Practice Address - Street 1:13016 EASTFIELD RD
Practice Address - Street 2:STE 200-336
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6622
Practice Address - Country:US
Practice Address - Phone:704-274-9062
Practice Address - Fax:866-268-3797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6343235Z00000X
NC6278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412127Medicaid
NC7412067Medicaid