Healthcare Provider Details

I. General information

NPI: 1619692100
Provider Name (Legal Business Name): AQUILA REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 15TH ST NW STE 801
WASHINGTON DC
20005-2616
US

IV. Provider business mailing address

1023 15TH ST NW STE 801
WASHINGTON DC
20005-2616
US

V. Phone/Fax

Practice location:
  • Phone: 202-244-1600
  • Fax: 202-521-0617
Mailing address:
  • Phone: 202-244-1600
  • Fax: 202-521-0617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCHWARTZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 201-290-1203