Provider Demographics
NPI:1932414604
Name:COMMUNITY REHAB INC.
Entity Type:Organization
Organization Name:COMMUNITY REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:THEILER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:402-721-3908
Mailing Address - Street 1:12301 N 149 CIRCLE
Mailing Address - Street 2:RIDGEWOOD CLUBHOUSE
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68007
Mailing Address - Country:US
Mailing Address - Phone:402-884-7644
Mailing Address - Fax:402-884-7525
Practice Address - Street 1:12301 NO. 149TH CIRCLE
Practice Address - Street 2:RIDGEWOOD CLUBHOUSE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68007
Practice Address - Country:US
Practice Address - Phone:402-884-7644
Practice Address - Fax:402-884-7525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy