Provider Demographics
NPI: | 1932421310 |
---|---|
Name: | REHAB PRACTICE MANAGEMENT, LLC |
Entity Type: | Organization |
Organization Name: | REHAB PRACTICE MANAGEMENT, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | COO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JENNIFER |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | SJOBLOM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 831-422-3700 |
Mailing Address - Street 1: | 215 LIGHTHOUSE TER |
Mailing Address - Street 2: | |
Mailing Address - City: | FRANKLIN |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37064-6126 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-591-5592 |
Mailing Address - Fax: | 615-301-3915 |
Practice Address - Street 1: | 215 LIGHTHOUSE TER |
Practice Address - Street 2: | |
Practice Address - City: | FRANKLIN |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37064-6126 |
Practice Address - Country: | US |
Practice Address - Phone: | 615-591-5592 |
Practice Address - Fax: | 615-301-3915 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-02-25 |
Last Update Date: | 2010-02-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | Group - Multi-Specialty |