Provider Demographics
NPI:1992858336
Name:COMMUNITY REHAB CENTER
Entity Type:Organization
Organization Name:COMMUNITY REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:COCKRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-312-2124
Mailing Address - Street 1:2800 N MILITARY TRL
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2951
Mailing Address - Country:US
Mailing Address - Phone:561-683-7733
Mailing Address - Fax:561-683-7726
Practice Address - Street 1:2800 N MILITARY TRL
Practice Address - Street 2:104
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2951
Practice Address - Country:US
Practice Address - Phone:561-683-7733
Practice Address - Fax:561-683-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization