Provider Demographics
NPI:1730361247
Name:REHABILITATION AND HEALTH CENTER, INC
Entity type:Organization
Organization Name:REHABILITATION AND HEALTH CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:PORTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:330-564-4100
Mailing Address - Street 1:50 BAKER BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3674
Mailing Address - Country:US
Mailing Address - Phone:330-865-1600
Mailing Address - Fax:
Practice Address - Street 1:27600 CHAGRIN BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4439
Practice Address - Country:US
Practice Address - Phone:330-865-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHABILITATION AND HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-27
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2706156Medicaid
OH2706156Medicaid