Provider Demographics
NPI:1205207461
Name:PARKINSON'S DISEASE REHABILITATION INSTITUTE
Entity Type:Organization
Organization Name:PARKINSON'S DISEASE REHABILITATION INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TERPSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-418-8377
Mailing Address - Street 1:2145 CENTRAL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45214-2376
Mailing Address - Country:US
Mailing Address - Phone:630-418-8377
Mailing Address - Fax:
Practice Address - Street 1:2145 CENTRAL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45214-2376
Practice Address - Country:US
Practice Address - Phone:630-418-8377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No251V00000XAgenciesVoluntary or Charitable