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General NPI Number Information
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NPI Number | 1063381333
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Entity Type | Organization
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Legal Business Name | GREAT STRIDES REHABILITATION INC.
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 12276 SAN JOSE BLVD STE 508
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City | JACKSONVILLE
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State | FL
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Zip | 32223-8618
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Country | US
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Telephone | 904-886-3228
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932184
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City | ATLANTA
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State | GA
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Zip | 31193-2184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | AMANDA STREETER
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Credential |
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Telephone | 800-699-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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