Provider Demographics
NPI:1225172380
Name:AT HOME THERAPEUTIC SOLUTIONS LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:AT HOME THERAPEUTIC SOLUTIONS LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:RABIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:732-887-8425
Mailing Address - Street 1:325 MANSFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2549
Mailing Address - Country:US
Mailing Address - Phone:732-887-8425
Mailing Address - Fax:732-985-5368
Practice Address - Street 1:325 MANSFIELD ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2549
Practice Address - Country:US
Practice Address - Phone:732-887-8425
Practice Address - Fax:732-985-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00765700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty