Provider Demographics
NPI:1578107694
Name:THERAHOME REHAB
Entity Type:Organization
Organization Name:THERAHOME REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIORA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLBACH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:973-930-1153
Mailing Address - Street 1:15 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 VALLEY RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1825
Practice Address - Country:US
Practice Address - Phone:973-930-1153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health