Provider Demographics
NPI:1710964887
Name:REHABILITATION CENTER FOR CHILDREN AND ADULTS
Entity Type:Organization
Organization Name:REHABILITATION CENTER FOR CHILDREN AND ADULTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-655-7266
Mailing Address - Street 1:300 ROYAL PALM WAY
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-4305
Mailing Address - Country:US
Mailing Address - Phone:561-655-7266
Mailing Address - Fax:561-655-3269
Practice Address - Street 1:300 ROYAL PALM WAY
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-4305
Practice Address - Country:US
Practice Address - Phone:561-655-7266
Practice Address - Fax:561-655-3269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2007-12-13
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
FL104506Medicare Oscar/Certification