Healthcare Provider Details

I. General information

NPI: 1174344618
Provider Name (Legal Business Name): REHABVISIONS THERAPY MO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11336 S 96TH ST STE 114
PAPILLION NE
68046-4211
US

IV. Provider business mailing address

11623 ARBOR ST STE 200
OMAHA NE
68144-2991
US

V. Phone/Fax

Practice location:
  • Phone: 402-315-3603
  • Fax: 402-315-3604
Mailing address:
  • Phone: 402-334-6025
  • Fax: 402-334-6025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. THERESA GODFREY
Title or Position: CLINIC ADMINISTRATIVE DIRECTOR
Credential:
Phone: 402-334-6025