Provider Demographics
NPI:1114598570
Name:CANARY REHAB
Entity Type:Organization
Organization Name:CANARY REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STAPLES-CANARY
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:413-289-4948
Mailing Address - Street 1:113 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01069-2135
Mailing Address - Country:US
Mailing Address - Phone:413-289-4948
Mailing Address - Fax:413-351-0226
Practice Address - Street 1:113 BOSTON RD
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-2135
Practice Address - Country:US
Practice Address - Phone:413-289-4948
Practice Address - Fax:413-351-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty