Provider Demographics
NPI:1770365009
Name:INTENSIVE SPECIALTY HOSPITAL, LLC
Entity type:Organization
Organization Name:INTENSIVE SPECIALTY HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSET MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-522-5970
Mailing Address - Street 1:150 AIRPORT RD STE 900
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6988
Mailing Address - Country:US
Mailing Address - Phone:732-370-4030
Mailing Address - Fax:
Practice Address - Street 1:1800 IRVING PL
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4608
Practice Address - Country:US
Practice Address - Phone:318-425-4096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTENSIVE SPECIALTY HOSPITAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-20
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit