Provider Demographics
NPI:1205201514
Name:AT HOME REHAB LLC
Entity Type:Organization
Organization Name:AT HOME REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUGLIELMI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:267-241-4010
Mailing Address - Street 1:800 W STATE ST
Mailing Address - Street 2:STE 103
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2250
Mailing Address - Country:US
Mailing Address - Phone:267-241-4010
Mailing Address - Fax:
Practice Address - Street 1:800 W STATE ST
Practice Address - Street 2:STE 103
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2250
Practice Address - Country:US
Practice Address - Phone:267-241-4010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA77860501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA449388Medicare Oscar/Certification