Provider Demographics
NPI:1760057368
Name:PRESCRIBED REHABILITATION, INC.
Entity Type:Organization
Organization Name:PRESCRIBED REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:850-345-6666
Mailing Address - Street 1:2325 KEITH ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-0904
Mailing Address - Country:US
Mailing Address - Phone:850-345-6666
Mailing Address - Fax:
Practice Address - Street 1:2860 HIGHWAY 71 STE B
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-1893
Practice Address - Country:US
Practice Address - Phone:850-345-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty