Healthcare Provider Details

I. General information

NPI: 1720791361
Provider Name (Legal Business Name): REHABVISIONS THERAPY NE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

683 STATE AVE STE C
DICKINSON ND
58601-4660
US

IV. Provider business mailing address

11623 ARBOR ST STE 200
OMAHA NE
68144-2991
US

V. Phone/Fax

Practice location:
  • Phone: 402-334-6063
  • Fax: 402-334-6063
Mailing address:
  • Phone: 402-334-6063
  • Fax: 402-334-6063

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: WENDY L MEAD
Title or Position: REGULATORY AND REIMBURSEMENT SPECIA
Credential:
Phone: 402-334-6063