Provider Demographics
NPI:1508935883
Name:FRIENDSHIP HEIGHTS REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:FRIENDSHIP HEIGHTS REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RODDA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-656-6922
Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE 604
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-656-6922
Mailing Address - Fax:301-656-6977
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 604
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-656-6922
Practice Address - Fax:301-656-6977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD58139261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02220Medicare ID - Type UnspecifiedFACILITY MEDICARE NUMBER