Provider Demographics
NPI:1245470657
Name:SIGNATURE REHAB SERVICES, LLC
Entity type:Organization
Organization Name:SIGNATURE REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELZEND
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:703-225-9477
Mailing Address - Street 1:5101C BACKLICK RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-6061
Mailing Address - Country:US
Mailing Address - Phone:703-225-9477
Mailing Address - Fax:
Practice Address - Street 1:5101C BACKLICK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-6061
Practice Address - Country:US
Practice Address - Phone:703-225-9477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1245470657Medicaid
VA177940Medicare Oscar/Certification