Provider Demographics
NPI:1609853431
Name:SARGENT REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:SARGENT REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAND
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-886-6600
Mailing Address - Street 1:800 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1667
Mailing Address - Country:US
Mailing Address - Phone:401-886-6600
Mailing Address - Fax:401-886-6632
Practice Address - Street 1:800 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02818-1667
Practice Address - Country:US
Practice Address - Phone:401-886-6600
Practice Address - Fax:401-886-6632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RISR21880Medicaid
41 6500Medicare ID - Type Unspecified
RISR21880Medicaid