Healthcare Provider Details

I. General information

NPI: 1487760799
Provider Name (Legal Business Name): FLAGSHIP REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18131 SLADE SCHOOL RD
SANDY SPRING MD
20860-1346
US

IV. Provider business mailing address

157 BALTIMORE ST SUITE 201
CUMBERLAND MD
21502-2319
US

V. Phone/Fax

Practice location:
  • Phone: 301-260-1690
  • Fax: 301-260-1075
Mailing address:
  • Phone: 301-722-3215
  • Fax: 301-722-1450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. WILLIAM E FREAS JR.
Title or Position: CEO
Credential: CCC-SLP
Phone: 301-722-3215