Healthcare Provider Details

I. General information

NPI: 1770283376
Provider Name (Legal Business Name): RWW HOME & COMMUNITY REHAB SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 GRIFFITH ST STE 206
DAVIDSON NC
28036-9307
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY STE 400
LOUISVILLE KY
40222-7102
US

V. Phone/Fax

Practice location:
  • Phone: 980-306-2017
  • Fax:
Mailing address:
  • Phone: 800-866-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANGIE MATTINGLY
Title or Position: MGR PROVIDER ENROLLMENT
Credential:
Phone: 502-630-7425