Provider Demographics
NPI:1215380290
Name:CENTER FOR WORK RECOVERY
Entity Type:Organization
Organization Name:CENTER FOR WORK RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-285-9797
Mailing Address - Street 1:PO BOX 5982
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23471-0982
Mailing Address - Country:US
Mailing Address - Phone:757-481-6701
Mailing Address - Fax:757-481-6175
Practice Address - Street 1:762 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE # 772
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6200
Practice Address - Country:US
Practice Address - Phone:757-481-6701
Practice Address - Fax:757-481-6175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty