Provider Demographics
NPI:1609249689
Name:SELECT REHABILITATION
Entity Type:Organization
Organization Name:SELECT REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:FISK
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-868-3600
Mailing Address - Street 1:8103 MAXFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2262
Mailing Address - Country:US
Mailing Address - Phone:301-742-8863
Mailing Address - Fax:
Practice Address - Street 1:9211 STUART LN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2712
Practice Address - Country:US
Practice Address - Phone:301-868-3600
Practice Address - Fax:240-318-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18665251E00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251E00000XAgenciesHome Health