Provider Demographics
NPI:1811021504
Name:THE REHAB CENTRE, INC.
Entity Type:Organization
Organization Name:THE REHAB CENTRE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PETRARCA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-478-1501
Mailing Address - Street 1:PO BOX 143
Mailing Address - Street 2:
Mailing Address - City:VANDERGRIFT
Mailing Address - State:PA
Mailing Address - Zip Code:15690-0143
Mailing Address - Country:US
Mailing Address - Phone:724-478-1501
Mailing Address - Fax:724-478-1552
Practice Address - Street 1:2131 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:NORTH APOLLO
Practice Address - State:PA
Practice Address - Zip Code:15673
Practice Address - Country:US
Practice Address - Phone:724-478-1501
Practice Address - Fax:724-478-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050162Medicare ID - Type Unspecified