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General NPI Number Information
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NPI Number | 1104268507
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Entity Type | Organization
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Legal Business Name | REHAB MANAGEMENT INC
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 4413 RIVERMILL CT
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City | PORTSMOUTH
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State | VA
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Zip | 23703-1573
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Country | US
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Telephone | 757-319-5757
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Fax |
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Provider Business Mailing Address
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Address Line | 4413 RIVERMILL CT
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City | PORTSMOUTH
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State | VA
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Zip | 23703-1573
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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 | COTA/L
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Name | DANIELLE LITTLE
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Credential |
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Telephone | 757-319-5757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 0131000446
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License Number State | VA
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