Provider Demographics
NPI:1376135707
Name:HUMAN PERFORMANCE AND REHABILITATION CENTERS, LLC
Entity Type:Organization
Organization Name:HUMAN PERFORMANCE AND REHABILITATION CENTERS, LLC
Other - Org Name:DBA MEDICAL AND HEALTH RESOURCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLUSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-324-3667
Mailing Address - Street 1:PO BOX 8068
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8068
Mailing Address - Country:US
Mailing Address - Phone:706-322-7762
Mailing Address - Fax:706-327-6157
Practice Address - Street 1:6298 VETERANS PKWY STE 5A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-6245
Practice Address - Country:US
Practice Address - Phone:706-324-3667
Practice Address - Fax:706-324-4609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies