Provider Demographics
NPI:1265825780
Name:ULTIMA REHAB LLC
Entity Type:Organization
Organization Name:ULTIMA REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:DUUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-509-2388
Mailing Address - Street 1:132 PEARLCROFT RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3334
Mailing Address - Country:US
Mailing Address - Phone:609-509-2388
Mailing Address - Fax:267-790-0402
Practice Address - Street 1:826 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-1071
Practice Address - Country:US
Practice Address - Phone:610-590-1385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontologyGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty