Provider Demographics
NPI:1588667430
Name:WEST REHAB SERVICES, INC.
Entity Type:Organization
Organization Name:WEST REHAB SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DHA
Authorized Official - Phone:912-658-1234
Mailing Address - Street 1:16 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TYBEE ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31328-8807
Mailing Address - Country:US
Mailing Address - Phone:912-658-2341
Mailing Address - Fax:
Practice Address - Street 1:16 10TH ST
Practice Address - Street 2:
Practice Address - City:TYBEE ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31328-8807
Practice Address - Country:US
Practice Address - Phone:912-658-2341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X, 235Z00000X, 261QR0400X
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00478981BMedicaid
GA000478981AMedicaid
GA000478981AMedicaid
GA000478981AMedicaid