Healthcare Provider Details

I. General information

NPI: 1376704031
Provider Name (Legal Business Name): ALLEGIANCE HOME REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SW 12TH AVE STE B
BOCA RATON FL
33486-6619
US

IV. Provider business mailing address

1700 SW 12TH AVE STE B
BOCA RATON FL
33486-6619
US

V. Phone/Fax

Practice location:
  • Phone: 561-367-0711
  • Fax: 561-367-0721
Mailing address:
  • Phone: 561-367-0711
  • Fax: 561-367-0721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT M OSOWSKI
Title or Position: VICE PRESIDENT
Credential:
Phone: 561-367-0711