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General NPI Number Information
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NPI Number | 1437297884
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Entity Type | Organization
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Legal Business Name | COBBLESTONE REHABILITATION, L.P.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 4102 BELMONT PT
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City | CHAMPAIGN
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State | IL
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Zip | 61822-3506
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Country | US
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Telephone | 217-366-0033
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Fax | 217-366-0012
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Provider Business Mailing Address
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Address Line | PO BOX 6694
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City | CHAMPAIGN
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State | IL
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Zip | 61826-6694
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Country | US
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Telephone | 217-366-0033
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Fax | 217-366-0012
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | ROBIN SPALDING
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Credential |
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Telephone | 217-366-0033
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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 | 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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Taxonomy #3
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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 #4
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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 #5
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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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