Provider Demographics
NPI:1407618713
Name:DRIFTLESS AREA REHABILITATION, LLC
Entity Type:Organization
Organization Name:DRIFTLESS AREA REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CLT, CWT
Authorized Official - Phone:319-360-3107
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55974-0595
Mailing Address - Country:US
Mailing Address - Phone:319-360-3107
Mailing Address - Fax:
Practice Address - Street 1:172 W MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:MN
Practice Address - Zip Code:55974-1444
Practice Address - Country:US
Practice Address - Phone:319-360-3107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty