Provider Demographics
NPI:1790115244
Name:NILECRAM REHAB GROUP LLC
Entity Type:Organization
Organization Name:NILECRAM REHAB GROUP LLC
Other - Org Name:ABSOLUTE WELLNESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:718-810-2317
Mailing Address - Street 1:4222 FORTUNA CENTER PLAZA
Mailing Address - Street 2:#108
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4222 FORTUNA CENTER PLZ
Practice Address - Street 2:#108
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1515
Practice Address - Country:US
Practice Address - Phone:866-644-8886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities