Provider Demographics
NPI:1851604482
Name:TOTAL REHAB AT HOME, INC.
Entity Type:Organization
Organization Name:TOTAL REHAB AT HOME, INC.
Other - Org Name:TOTAL REHAB AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERI
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:KUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-392-2731
Mailing Address - Street 1:139 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5624
Mailing Address - Country:US
Mailing Address - Phone:410-392-2731
Mailing Address - Fax:410-392-2732
Practice Address - Street 1:139 E HIGH ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5624
Practice Address - Country:US
Practice Address - Phone:410-392-2731
Practice Address - Fax:410-392-2732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-25
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty