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General NPI Number Information
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NPI Number | 1629393566
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Entity Type | Organization
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Legal Business Name | ADVANCED REHAB SERVICES
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Dates
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Enumeration Date | 04/04/2010
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Last Update Date | 01/30/2011
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Provider Practice Location Address
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Address Line | 645 LAFAYETTE RD
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City | MEDINA
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State | OH
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Zip | 44256-2341
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Country | US
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Telephone | 330-952-1031
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Fax |
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Provider Business Mailing Address
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Address Line | 645 LAFAYETTE RD
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City | MEDINA
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State | OH
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Zip | 44256-2341
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Country | US
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Telephone | 330-952-1031
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. KURTIS WAYNE MANGES
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Credential |
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Telephone | 330-948-1107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | OH
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