Provider Demographics
NPI:1114088531
Name:INTEGRATED REHAB, LLC
Entity Type:Organization
Organization Name:INTEGRATED REHAB, LLC
Other - Org Name:LIFELINE SPECIALTY OUTPATIENT CENTERS-PHYSICAL AND PULMONARY REHABILIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BREHM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:412-351-6545
Mailing Address - Street 1:2600 ARDMORE BLVD
Mailing Address - Street 2:100 FOREST HILLS PLAZA
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-5208
Mailing Address - Country:US
Mailing Address - Phone:412-351-6545
Mailing Address - Fax:412-829-6428
Practice Address - Street 1:2600 ARDMORE BLVD
Practice Address - Street 2:100 FOREST HILLS PLAZA
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-5208
Practice Address - Country:US
Practice Address - Phone:412-351-6545
Practice Address - Fax:412-829-6428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0131046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTAX ID