Provider Demographics
NPI:1235673989
Name:REHABFOCUS LLC
Entity Type:Organization
Organization Name:REHABFOCUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL CONSTANCIO
Authorized Official - Middle Name:RESPICIO
Authorized Official - Last Name:MAHINAY
Authorized Official - Suffix:VI
Authorized Official - Credentials:PT
Authorized Official - Phone:812-549-6512
Mailing Address - Street 1:3325 YALE DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-7305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1250 MAIN ST
Practice Address - Street 2:#1282
Practice Address - City:MOUNT VERNON
Practice Address - State:IN
Practice Address - Zip Code:47620
Practice Address - Country:US
Practice Address - Phone:812-549-6512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty