Provider Demographics
NPI:1962632075
Name:REHAB1,LLC
Entity Type:Organization
Organization Name:REHAB1,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:610-453-6986
Mailing Address - Street 1:613 CRICKLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8507
Mailing Address - Country:US
Mailing Address - Phone:610-453-6986
Mailing Address - Fax:610-399-0401
Practice Address - Street 1:613 CRICKLEWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-8507
Practice Address - Country:US
Practice Address - Phone:610-453-6986
Practice Address - Fax:610-399-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010606225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty