Provider Demographics
NPI:1437438546
Name:COMPLETE REHAB & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:COMPLETE REHAB & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:K
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:402-339-2283
Mailing Address - Street 1:9825 GILES RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2927
Mailing Address - Country:US
Mailing Address - Phone:402-339-2283
Mailing Address - Fax:402-339-2289
Practice Address - Street 1:9825 GILES RD
Practice Address - Street 2:SUITE F
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2927
Practice Address - Country:US
Practice Address - Phone:402-339-2283
Practice Address - Fax:402-339-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-06
Last Update Date:2011-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty