Provider Demographics
NPI:1144674870
Name:HANA REHAB CLINIC,INC
Entity type:Organization
Organization Name:HANA REHAB CLINIC,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:617-731-1001
Mailing Address - Street 1:39 BRIGHTON AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2301
Mailing Address - Country:US
Mailing Address - Phone:617-731-1001
Mailing Address - Fax:617-903-4134
Practice Address - Street 1:39 BRIGHTON AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2301
Practice Address - Country:US
Practice Address - Phone:617-731-1001
Practice Address - Fax:617-903-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18660261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy