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General NPI Number Information
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NPI Number | 1205880879
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Entity Type | Organization
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Legal Business Name | GL REHABILITATION SERVICES LTD
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 470 GARFIELD AVE
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City | EVANSVILLE
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State | WI
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Zip | 53536-1014
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Country | US
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Telephone | 608-882-6557
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Fax | 608-882-6559
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Provider Business Mailing Address
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Address Line | 2620 WAUNONA WAY
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City | MADISON
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State | WI
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Zip | 53713-1525
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Country | US
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Telephone | 608-223-1452
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Fax | 608-223-1459
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Authorized Official
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Title or Position | REHABILITATION AGENCY ADMINISTRATOR
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Name | MS. ILENE L LARSON
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Credential | PT MS
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Telephone | 608-223-1452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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