Healthcare Provider Details

I. General information

NPI: 1114347465
Provider Name (Legal Business Name): REHAB MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 E VIRGINIA AVE
PHOENIX AZ
85004-1214
US

IV. Provider business mailing address

370 E VIRGINIA AVE
PHOENIX AZ
85004-1214
US

V. Phone/Fax

Practice location:
  • Phone: 480-206-6240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: CARY EDGAR
Title or Position: MEMBER
Credential:
Phone: 480-206-6240