Provider Demographics
NPI:1851834675
Name:ELMWOOD THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:ELMWOOD THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BERARDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-559-5115
Mailing Address - Street 1:871 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-9701
Mailing Address - Country:US
Mailing Address - Phone:330-568-8127
Mailing Address - Fax:330-568-8084
Practice Address - Street 1:871 ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-9701
Practice Address - Country:US
Practice Address - Phone:330-568-8127
Practice Address - Fax:330-568-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation