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General NPI Number Information
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NPI Number | 1982792099
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Entity Type | Organization
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Legal Business Name | JVS REHABILITATION, INC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 10632 LITTLE PATUXENT PKWY SUITE 129
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City | COLUMBIA
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State | MD
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Zip | 21044-3273
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Country | US
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Telephone | 410-740-0300
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Fax | 410-740-0302
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Provider Business Mailing Address
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Address Line | 10632 LITTLE PATUXENT PKWY SUITE 129
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City | COLUMBIA
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State | MD
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Zip | 21044-3273
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Country | US
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Telephone | 410-740-0300
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Fax | 410-740-0302
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MR. MARK R SALLITT
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Credential |
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Telephone | 410-740-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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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