Provider Demographics
NPI:1164392296
Name:HOMEBASE REHABILITATION LLC
Entity type:Organization
Organization Name:HOMEBASE REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:845-797-3371
Mailing Address - Street 1:8407 CRESCENT MOON DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-3021
Mailing Address - Country:US
Mailing Address - Phone:845-797-3371
Mailing Address - Fax:
Practice Address - Street 1:8407 CRESCENT MOON DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-3021
Practice Address - Country:US
Practice Address - Phone:845-797-3371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty