Healthcare Provider Details

I. General information

NPI: 1730473059
Provider Name (Legal Business Name): REHABPRN SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 ANAPUNI ST #301
HONOLULU HI
96822-4482
US

IV. Provider business mailing address

PO BOX 37252
HONOLULU HI
96837-0252
US

V. Phone/Fax

Practice location:
  • Phone: 808-348-7747
  • Fax: 808-356-0888
Mailing address:
  • Phone: 808-554-2104
  • Fax: 808-356-0888

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: TARA TANNENHOLZ
Title or Position: CEO
Credential: PT
Phone: 808-348-7747