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NPI Code Detail

MEDICARE: GREAT STRIDES REHABILITATION INC.

MEDICARE: GREAT STRIDES REHABILITATION INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1013779768
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREAT STRIDES REHABILITATION INC.
Provider Business Mailing Address
First Line : PO BOX 932184
Second Line :
City : ATLANTA
State : GA
Zip : 31193-2184
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4365 STARKEY RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0610
Country : US
Telephone Number : 904-886-3228
Fax Number :
Authorized Official
Title or Position : CHIEF ADMINISTRATIVE OFFICER
Name : AMANDA STREETER
Credential :
Telephone Number : 800-699-9395
Provider Enumeration Date : 01/29/2024
Last Update Date : 06/10/2025

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Directions to “GREAT STRIDES REHABILITATION INC. ” Practice Location

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