Healthcare Provider Details

I. General information

NPI: 1841622396
Provider Name (Legal Business Name): ADVENTIST REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12041 BOURNEFIELD WAY STE B
SILVER SPRING MD
20904-7908
US

IV. Provider business mailing address

820 W DIAMOND AVE STE 500
GAITHERSBURG MD
20878-1469
US

V. Phone/Fax

Practice location:
  • Phone: 301-592-4400
  • Fax:
Mailing address:
  • Phone: 301-315-3102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES LEE
Title or Position: EVP & CFO
Credential:
Phone: 301-315-3030