Provider Demographics
NPI:1366484917
Name:REHAB PROFESSIONALS OF CLEVELAND, INC.
Entity Type:Organization
Organization Name:REHAB PROFESSIONALS OF CLEVELAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:AUBE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:440-526-8566
Mailing Address - Street 1:7000 TOWN CENTRE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-4008
Mailing Address - Country:US
Mailing Address - Phone:440-526-8566
Mailing Address - Fax:440-546-8280
Practice Address - Street 1:7000 TOWN CENTRE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-4008
Practice Address - Country:US
Practice Address - Phone:440-526-8566
Practice Address - Fax:440-546-8280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH167835OtherANTHEM BC BS
OH64-00247OtherUNITED HEALTHCARE
OH2170994Medicaid
OH302608368-005OtherMEDICAL MUTUAL OF OH
OH=========00OtherOH BUREAU OF WORKERS COMP
OH64-00247OtherUNITED HEALTHCARE