Provider Demographics
NPI:1356628101
Name:REHAB WITHOUT WALLS, INC.
Entity Type:Organization
Organization Name:REHAB WITHOUT WALLS, INC.
Other - Org Name:RWW SAN JOSE
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOC.GEN.COUNSEL/PRIVACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:G
Authorized Official - Last Name:OMBRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-394-2387
Mailing Address - Street 1:9901 LINN STATION RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3808
Mailing Address - Country:US
Mailing Address - Phone:502-394-2100
Mailing Address - Fax:502-394-2285
Practice Address - Street 1:2155 S BASCOM AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-3272
Practice Address - Country:US
Practice Address - Phone:800-403-3352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care