Healthcare Provider Details

I. General information

NPI: 1558186866
Provider Name (Legal Business Name): NEURO REHAB MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1437 HAVERHILL CT
DELAWARE OH
43015-4903
US

IV. Provider business mailing address

PO BOX 245
LEWIS CENTER OH
43035-0245
US

V. Phone/Fax

Practice location:
  • Phone: 216-392-7936
  • Fax:
Mailing address:
  • Phone: 216-392-7936
  • Fax: 516-346-5075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KENDRA HILL
Title or Position: OWNER
Credential: MD
Phone: 216-392-7936