Provider Demographics
NPI:1831313444
Name:THE TREHAB CENTER INC
Entity Type:Organization
Organization Name:THE TREHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PHELPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-278-5227
Mailing Address - Street 1:10 PUBLIC AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1220
Mailing Address - Country:US
Mailing Address - Phone:570-278-5227
Mailing Address - Fax:570-278-1889
Practice Address - Street 1:10 PUBLIC AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-1220
Practice Address - Country:US
Practice Address - Phone:570-278-5227
Practice Address - Fax:570-278-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007301450004Medicaid