MEDICARE: HEALTHREACH REHABILITATION SERVICES, 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
1	261QR0400X	Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548242829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHREACH REHABILITATION SERVICES, INC.

Provider Business Mailing Address
First Line	:	17280 W NORTH AVE
Second Line	:	#104
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-4366
Country	:	US
Telephone Number	:	262-780-0707
Fax Number	:	262-780-0717

Provider Business Practice Location Address
First Line	:	17280 W NORTH AVE
Second Line	:	#104
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-4366
Country	:	US
Telephone Number	:	262-780-0707
Fax Number	:	262-780-0717

Authorized Official
Title or Position	:	HR DIRECTOR
Name	:	LISA BOOZ
Credential	:
Telephone Number	:	262-780-0707

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	08/22/2020

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