Provider Demographics
NPI:1457863607
Name:TRUREHAB OUTPATIENT LLC
Entity Type:Organization
Organization Name:TRUREHAB OUTPATIENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-868-1222
Mailing Address - Street 1:12251 HIGHWAY 41 N STE A
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-7014
Mailing Address - Country:US
Mailing Address - Phone:812-868-1222
Mailing Address - Fax:866-774-0493
Practice Address - Street 1:12251 HIGHWAY 41 N STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-7014
Practice Address - Country:US
Practice Address - Phone:812-868-1222
Practice Address - Fax:866-774-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation