Provider Demographics
NPI:1144568213
Name:PEARL REHABILITATION LLC
Entity Type:Organization
Organization Name:PEARL REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEFANI
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANKENY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:770-378-5014
Mailing Address - Street 1:3052 ARGYLL DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-8390
Mailing Address - Country:US
Mailing Address - Phone:770-378-5014
Mailing Address - Fax:
Practice Address - Street 1:3052 ARGYLL DR
Practice Address - Street 2:MENDENHALL ST
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-8390
Practice Address - Country:US
Practice Address - Phone:770-378-5014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3816251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health