Healthcare Provider Details

I. General information

NPI: 1275526725
Provider Name (Legal Business Name): ADULT SERVICES UNLIMITED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 07/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S. RIVER STREET
PLAINS PA
18705-1137
US

IV. Provider business mailing address

111 WEST MICHIGAN STREET
MILWAUKEE WI
53203-2903
US

V. Phone/Fax

Practice location:
  • Phone: 570-824-3444
  • Fax: 570-824-4021
Mailing address:
  • Phone: 414-908-8119
  • Fax: 414-908-7105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ROCH CARTER
Title or Position: VICE PRESIDENT
Credential:
Phone: 414-908-8221