Healthcare Provider Details

I. General information

NPI: 1235602350
Provider Name (Legal Business Name): THE REHAB HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 MELLON ST SE
WASHINGTON DC
20032-2537
US

IV. Provider business mailing address

623 MELLON ST SE
WASHINGTON DC
20032-2537
US

V. Phone/Fax

Practice location:
  • Phone: 301-806-4791
  • Fax:
Mailing address:
  • Phone: 301-806-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225CX0006X
TaxonomyOrientation and Mobility Training Rehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: DR. LATONJA DESHAWN CARRERA
Title or Position: COO
Credential: PHD
Phone: 301-806-4791