Provider Demographics
NPI:1649726571
Name:REHAB EXCELLENCE CENTER, LLC
Entity type:Organization
Organization Name:REHAB EXCELLENCE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-910-1200
Mailing Address - Street 1:6981 N PARK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-4205
Mailing Address - Country:US
Mailing Address - Phone:856-910-1200
Mailing Address - Fax:856-910-7800
Practice Address - Street 1:900 ROUTE 168
Practice Address - Street 2:SUITE A-8
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3233
Practice Address - Country:US
Practice Address - Phone:856-227-1440
Practice Address - Fax:856-227-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01690700261QP2000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ070451OtherPTAN