Provider Demographics
NPI:1275526725
Name:ADULT SERVICES UNLIMITED, INC.
Entity Type:Organization
Organization Name:ADULT SERVICES UNLIMITED, INC.
Other - Org Name:RIVERSIDE REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROCH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-908-8221
Mailing Address - Street 1:111 WEST MICHIGAN STREET
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-2903
Mailing Address - Country:US
Mailing Address - Phone:414-908-8119
Mailing Address - Fax:414-908-7105
Practice Address - Street 1:220 S. RIVER STREET
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1137
Practice Address - Country:US
Practice Address - Phone:570-824-3444
Practice Address - Fax:570-824-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA42659OtherGEISINGER
PA50013006OtherCAPITAL BLUE CROSS
PA1463894Medicaid
PA01903276Medicaid
PA372927OtherBLUE SHIELD
PA538523OtherAETNA US HEALTHCARE
PA815236OtherFIRST PRIORITY HEALTH
PA394508Medicare Oscar/Certification