Provider Demographics
NPI:1770537821
Name:REHABCARE GROUP EAST, LLC
Entity type:Organization
Organization Name:REHABCARE GROUP EAST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:1513 SCALP AVENUE
Mailing Address - Street 2:UNIT 260
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3331
Mailing Address - Country:US
Mailing Address - Phone:814-269-4108
Mailing Address - Fax:814-269-2370
Practice Address - Street 1:1513 SCALP AVENUE
Practice Address - Street 2:UNIT 260
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904
Practice Address - Country:US
Practice Address - Phone:814-269-4108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101388157 0002Medicaid
PA101388157 0003Medicaid
PA396608Medicare Oscar/Certification