Provider Demographics
NPI:1861498016
Name:THERAPY CENTER OF ENGLEWOOD,LLC
Entity Type:Organization
Organization Name:THERAPY CENTER OF ENGLEWOOD,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-894-9900
Mailing Address - Street 1:180 N DEAN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2534
Mailing Address - Country:US
Mailing Address - Phone:201-894-9900
Mailing Address - Fax:
Practice Address - Street 1:180 N DEAN ST
Practice Address - Street 2:STE 1
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2534
Practice Address - Country:US
Practice Address - Phone:201-894-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22972261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ314510Medicare ID - Type Unspecified