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General NPI Number Information
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NPI Number | 1871165019
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Entity Type | Organization
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Legal Business Name | RENEWED STRENGTH THERAPY CENTER, LLC
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 3302 WEST LAKE ROAD APARTMENT #126
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City | ERIE
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State | PA
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Zip | 16505-3677
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Country | US
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Telephone | 847-644-1280
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Fax | 847-440-9000
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Provider Business Mailing Address
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Address Line | 3302 WEST LAKE ROAD APARTMENT #126
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City | ERIE
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State | PA
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Zip | 16505-4339
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Country | US
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Telephone | 847-644-1280
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Fax | 847-440-9000
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Authorized Official
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Title or Position | OT/REHABILITATION DIRECTOR
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Name | MR. MARK HOWARD CABLE
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Credential | MS, OTR/L, CFPS
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Telephone | 847-644-1280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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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 | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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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 | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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