Provider Demographics
NPI:1649340704
Name:COMMUNITY REHAB CARE, INC
Entity type:Organization
Organization Name:COMMUNITY REHAB CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHERNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-744-8300
Mailing Address - Street 1:51 WATER STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472
Mailing Address - Country:US
Mailing Address - Phone:617-744-8300
Mailing Address - Fax:617-744-6218
Practice Address - Street 1:51 WATER STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472
Practice Address - Country:US
Practice Address - Phone:617-744-8300
Practice Address - Fax:617-744-6218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1311026Medicaid
MA226525Medicare ID - Type Unspecified