Provider Demographics
NPI:1326686049
Name:PRIORITY WELLNESS AND REHAB LLC
Entity Type:Organization
Organization Name:PRIORITY WELLNESS AND REHAB LLC
Other - Org Name:PRIORITY REHAB AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARISHANTHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAGRIDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-652-1584
Mailing Address - Street 1:2070 W 106TH ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7918
Mailing Address - Country:US
Mailing Address - Phone:317-652-1584
Mailing Address - Fax:
Practice Address - Street 1:1703 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2076
Practice Address - Country:US
Practice Address - Phone:317-688-7560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty