Provider Demographics
NPI:1801808449
Name:WSB REHABILITATION SERVICES, INC
Entity type:Organization
Organization Name:WSB REHABILITATION SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:URIOSTE
Authorized Official - Suffix:
Authorized Official - Credentials:CONTROLLER
Authorized Official - Phone:330-702-0110
Mailing Address - Street 1:510 W MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1454
Mailing Address - Country:US
Mailing Address - Phone:330-702-0110
Mailing Address - Fax:330-702-0510
Practice Address - Street 1:4329 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1974
Practice Address - Country:US
Practice Address - Phone:330-702-0110
Practice Address - Fax:330-702-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9366081Medicare PIN
OH4200671Medicare PIN