Healthcare Provider Details

I. General information

NPI: 1811907462
Provider Name (Legal Business Name): GREENFIELD REHABILITATION AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 GATEWAY RD STE 100
BROOKFIELD WI
53045-5115
US

IV. Provider business mailing address

3360 GATEWAY RD STE 100
BROOKFIELD WI
53045-5115
US

V. Phone/Fax

Practice location:
  • Phone: 262-923-7178
  • Fax: 262-923-7178
Mailing address:
  • Phone: 262-923-7101
  • Fax: 262-923-7178

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: KATHERINE A BREWER
Title or Position: PRESIDENT/OWNER
Credential: PT, MBA, GCS, RAC-CT
Phone: 262-923-7101