Provider Demographics
NPI:1255354288
Name:NEURO REHAB ASSOCIATES, INC
Entity type:Organization
Organization Name:NEURO REHAB ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMPAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-890-3002
Mailing Address - Street 1:70 BUTLER STREET
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3925
Mailing Address - Country:US
Mailing Address - Phone:603-893-2900
Mailing Address - Fax:603-898-1372
Practice Address - Street 1:70 BUTLER STREET
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3925
Practice Address - Country:US
Practice Address - Phone:603-893-2900
Practice Address - Fax:603-898-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02362283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH903109OtherTUFTS HEALTH PLAN OPD
NH303026OtherNEW HAMPSHIRE BX
NH22626OtherFALLON HEALTH PLAN OPD
NH902904OtherHPHC OUTPATIENT
MA7201605Medicaid
NH2230302601OtherMASS BC& BS
NH5004003OtherUNITED HEALTHCARE OPD
NH80303026Medicaid
NH900966OtherTUFTS HEALTH PLAN INP
NH5000031OtherUNITED HEALTHCARE INP
NH986847OtherNETWORK HEALTH
NH42098OtherFALLON HEALTH PLAN
NH902904OtherHPHC INPATIENT
NH22626OtherFALLON HEALTH PLAN OPD
NH986847OtherNETWORK HEALTH
NHRE3499Medicare UPIN