Provider Demographics
NPI:1497920227
Name:REHAB CARE
Entity Type:Organization
Organization Name:REHAB CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BRINSON-MCDUFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:AAS
Authorized Official - Phone:414-416-3479
Mailing Address - Street 1:3904 W ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-1843
Mailing Address - Country:US
Mailing Address - Phone:414-416-3479
Mailing Address - Fax:
Practice Address - Street 1:1414 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-3018
Practice Address - Country:US
Practice Address - Phone:414-277-8854
Practice Address - Fax:414-276-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI993-019314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility