Provider Demographics
NPI:1396842811
Name:REHABILITATION TODAY SERVICES FOR PSYCHOLOGY ET AL PLLC
Entity Type:Organization
Organization Name:REHABILITATION TODAY SERVICES FOR PSYCHOLOGY ET AL PLLC
Other - Org Name:REHABILITATION TODAY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-372-2808
Mailing Address - Street 1:2416 CONSTITUTION AVE
Mailing Address - Street 2:REHABILITATION TODAY SERVICES PLLC
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760
Mailing Address - Country:US
Mailing Address - Phone:716-372-2808
Mailing Address - Fax:716-372-2902
Practice Address - Street 1:784 MAIN STREET
Practice Address - Street 2:REHABILITATION TODAY SERVICES
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760
Practice Address - Country:US
Practice Address - Phone:716-372-3550
Practice Address - Fax:716-372-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010040250001Medicaid
NYAA1539Medicare ID - Type Unspecified