Provider Demographics
NPI:1740237486
Name:FLEXEON REHABILITATION OF HOBART, LLC
Entity type:Organization
Organization Name:FLEXEON REHABILITATION OF HOBART, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:JUDGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:219-979-2730
Mailing Address - Street 1:1437 S LAKE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6635
Mailing Address - Country:US
Mailing Address - Phone:219-947-3637
Mailing Address - Fax:219-764-8533
Practice Address - Street 1:1437 S LAKE PARK AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6635
Practice Address - Country:US
Practice Address - Phone:219-947-3637
Practice Address - Fax:219-947-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDB4510Medicare PIN
IN189890Medicare PIN