Healthcare Provider Details

I. General information

NPI: 1568085579
Provider Name (Legal Business Name): ADAPTIVE REHABILITATION CLINICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2020
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date: 03/09/2022
Reactivation Date: 03/24/2022

III. Provider practice location address

2565 NILES VIENNA RD STE 109
NILES OH
44446-4401
US

IV. Provider business mailing address

7251 ENGLE RD STE 350
MIDDLEBURG HEIGHTS OH
44130-3419
US

V. Phone/Fax

Practice location:
  • Phone: 216-772-1030
  • Fax:
Mailing address:
  • Phone: 877-241-5783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE BOX
Title or Position: CEO
Credential:
Phone: 216-577-8532