Provider Demographics
NPI:1811216088
Name:INFINITY REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:INFINITY REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUTKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:413-592-3748
Mailing Address - Street 1:1981 MEMORIAL DR
Mailing Address - Street 2:#217
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4322
Mailing Address - Country:US
Mailing Address - Phone:413-888-2467
Mailing Address - Fax:
Practice Address - Street 1:1981 MEMORIAL DR
Practice Address - Street 2:#217
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-4322
Practice Address - Country:US
Practice Address - Phone:413-888-2467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8415172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty