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General NPI Number Information
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NPI Number | 1245571769
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Entity Type | Organization
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Legal Business Name | ENESIS REHAB SERVICES
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 10155 FOAL RD
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City | LAKE WORTH
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State | FL
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Zip | 33449-5446
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Country | US
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Telephone | 201-323-9834
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Fax |
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Provider Business Mailing Address
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Address Line | 10155 FOAL RD
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City | LAKE WORTH
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State | FL
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Zip | 33449-5446
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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 | PT
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Name | MARY WRINN
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Credential | PT
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Telephone | 18008044404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | OT12746
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License Number State | FL
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