Healthcare Provider Details

I. General information

NPI: 1053319491
Provider Name (Legal Business Name): PEAK REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 MARYLAND HWY
MT LAKE PARK MD
21550-6346
US

IV. Provider business mailing address

1477 MARYLAND HWY
MT LAKE PARK MD
21550-6346
US

V. Phone/Fax

Practice location:
  • Phone: 301-533-1010
  • Fax: 301-334-3059
Mailing address:
  • Phone: 301-533-1010
  • Fax: 301-334-3059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DEBRA E. FRIEND
Title or Position: VICE PRESIDENT
Credential: PHD CCC SLP
Phone: 301-533-1010