Provider Demographics
NPI:1194379842
Name:ITHRIVE REHAB GROUP
Entity Type:Organization
Organization Name:ITHRIVE REHAB GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-815-0183
Mailing Address - Street 1:1823 ATTAYA RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1823 ATTAYA RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2902
Practice Address - Country:US
Practice Address - Phone:773-552-9859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty