Provider Demographics
NPI:1942823026
Name:PREMIER REHAB SERVICESLLC
Entity Type:Organization
Organization Name:PREMIER REHAB SERVICESLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEILL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-203-9707
Mailing Address - Street 1:2374 FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-0979
Mailing Address - Country:US
Mailing Address - Phone:732-364-3325
Mailing Address - Fax:
Practice Address - Street 1:2374 FOREST CIR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-0979
Practice Address - Country:US
Practice Address - Phone:732-364-3325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy