Provider Demographics
NPI:1518310176
Name:HUGHES COMMUNITY REHABILITATION INCORPORATION
Entity Type:Organization
Organization Name:HUGHES COMMUNITY REHABILITATION INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:NAKEISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-902-9635
Mailing Address - Street 1:6648 WIND JAMMER WAY APT 103
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-6960
Mailing Address - Country:US
Mailing Address - Phone:219-902-9635
Mailing Address - Fax:
Practice Address - Street 1:6648 WIND JAMMER WAY APT 103
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-6960
Practice Address - Country:US
Practice Address - Phone:219-902-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN343900000XMedicaid