Healthcare Provider Details

I. General information

NPI: 1376652115
Provider Name (Legal Business Name): COMMUNITY REHAB, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 8TH AVE SUITE 8
PLATTSMOUTH NE
68048-2367
US

IV. Provider business mailing address

2380 8TH AVE STE 8
PLATTSMOUTH NE
68048-2367
US

V. Phone/Fax

Practice location:
  • Phone: 402-296-3433
  • Fax: 402-296-3531
Mailing address:
  • Phone: 402-296-3433
  • Fax: 402-296-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberN/A
License Number StateNE

VIII. Authorized Official

Name: MARY J THEILER
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: MPT
Phone: 402-721-3908