Provider Demographics
NPI:1912193327
Name:REHAB ASSESSMENT, LLC
Entity Type:Organization
Organization Name:REHAB ASSESSMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:QUINCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-896-0904
Mailing Address - Street 1:163 STRATFORD CT STE 236
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1836
Mailing Address - Country:US
Mailing Address - Phone:336-896-0904
Mailing Address - Fax:
Practice Address - Street 1:163 STRATFORD CT STE 236
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1836
Practice Address - Country:US
Practice Address - Phone:336-896-0904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health