Provider Demographics
NPI:1508084641
Name:ADVANCED REHABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:ADVANCED REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:406-752-7250
Mailing Address - Street 1:175 COMMONS LOOP
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1904
Mailing Address - Country:US
Mailing Address - Phone:406-752-7250
Mailing Address - Fax:406-752-6250
Practice Address - Street 1:175 COMMONS LOOP
Practice Address - Street 2:SUITE 100
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1904
Practice Address - Country:US
Practice Address - Phone:406-752-7250
Practice Address - Fax:406-752-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT011000663Medicare UPIN