Healthcare Provider Details

I. General information

NPI: 1720295306
Provider Name (Legal Business Name): REHABILITATION CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 W CAMPUS OVAL SUITE 150
NEW ALBANY OH
43054-8830
US

IV. Provider business mailing address

6525 W CAMPUS OVAL SUITE 150
NEW ALBANY OH
43054-8830
US

V. Phone/Fax

Practice location:
  • Phone: 614-433-2020
  • Fax: 614-433-2021
Mailing address:
  • Phone: 614-433-2020
  • Fax: 614-433-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NINO DIIULLO
Title or Position: OWNER
Credential: M.D.
Phone: 614-781-4138