Provider Demographics
NPI:1417270075
Name:REHABILITATIVE RESOURCES, INC.
Entity Type:Organization
Organization Name:REHABILITATIVE RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEEFE-LAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:508-347-8181
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:1 PICKER ROAD
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-0038
Mailing Address - Country:US
Mailing Address - Phone:508-347-8181
Mailing Address - Fax:508-347-3149
Practice Address - Street 1:1 PICKER RD
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1252
Practice Address - Country:US
Practice Address - Phone:508-347-8181
Practice Address - Fax:508-347-3149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110028181D311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110028181DMedicaid