Provider Demographics
NPI:1285817676
Name:INTEGRITY REHAB, LLC
Entity Type:Organization
Organization Name:INTEGRITY REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-385-1174
Mailing Address - Street 1:1455 VIA DE PEPI
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8279
Mailing Address - Country:US
Mailing Address - Phone:561-385-1174
Mailing Address - Fax:561-734-6452
Practice Address - Street 1:1455 VIA DE PEPI
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8279
Practice Address - Country:US
Practice Address - Phone:561-385-1174
Practice Address - Fax:561-734-6452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-09
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22161251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health