Provider Demographics
NPI:1235602350
Name:THE REHAB HOUSE
Entity Type:Organization
Organization Name:THE REHAB HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:LATONJA
Authorized Official - Middle Name:DESHAWN
Authorized Official - Last Name:CARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-806-4791
Mailing Address - Street 1:623 MELLON ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2537
Mailing Address - Country:US
Mailing Address - Phone:301-806-4791
Mailing Address - Fax:
Practice Address - Street 1:623 MELLON ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2537
Practice Address - Country:US
Practice Address - Phone:301-806-4791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training ProviderGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty