Provider Demographics
NPI:1700117694
Name:OCCUPATIONAL REHABILITATION SPECIALISTS, LLC
Entity Type:Organization
Organization Name:OCCUPATIONAL REHABILITATION SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ARAGON
Authorized Official - Suffix:
Authorized Official - Credentials:MS ,OTR
Authorized Official - Phone:269-268-5601
Mailing Address - Street 1:4609 GRAPE RD
Mailing Address - Street 2:SUITE B7
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-2649
Mailing Address - Country:US
Mailing Address - Phone:269-268-4601
Mailing Address - Fax:269-699-5431
Practice Address - Street 1:4609 GRAPE RD
Practice Address - Street 2:SUITE B7
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-2649
Practice Address - Country:US
Practice Address - Phone:269-268-4601
Practice Address - Fax:269-699-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-17
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center