Provider Demographics
NPI:1306212824
Name:ROLLING FIELDS INC
Entity Type:Organization
Organization Name:ROLLING FIELDS INC
Other - Org Name:THERAPY CARE AT THE FIELDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-338-9766
Mailing Address - Street 1:9108 STATE HIGHWAY 198
Mailing Address - Street 2:
Mailing Address - City:CONNEAUTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16406-2646
Mailing Address - Country:US
Mailing Address - Phone:814-587-2012
Mailing Address - Fax:
Practice Address - Street 1:9108 STATE HIGHWAY 198
Practice Address - Street 2:
Practice Address - City:CONNEAUTVILLE
Practice Address - State:PA
Practice Address - Zip Code:16406-2646
Practice Address - Country:US
Practice Address - Phone:814-587-2012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROLLING FILEDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-19
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001344640003Medicaid