Healthcare Provider Details

I. General information

NPI: 1679617963
Provider Name (Legal Business Name): CHESTNUT HILL REHAB HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 STENTON AVE
WYNDMOOR PA
19038-8312
US

IV. Provider business mailing address

1022 MAIN ST SUITE H
DUNEDIN FL
34698-5238
US

V. Phone/Fax

Practice location:
  • Phone: 215-233-6200
  • Fax:
Mailing address:
  • Phone: 727-723-3000
  • Fax: 727-723-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number010401
License Number StatePA

VIII. Authorized Official

Name: MR. BEN ATKINS
Title or Position: CEO
Credential:
Phone: 727-723-3000