Basic Information
Provider Information
NPI: 1235519398
EntityType: 2
ReplacementNPI:  
OrganizationName: H2 HEALTH AND REHABILITATION SERVICES, LLC
LastName:  
FirstName:  
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Credential:  
OtherOrganizationName: H2 HEALTH
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 484 RIVERSIDE AVE
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322024912
CountryCode: US
TelephoneNumber: 8006999395
FaxNumber: 9049444063
Practice Location
Address1: 220 S RIVER ST
Address2:  
City: PLAINS
State: PA
PostalCode: 187051137
CountryCode: US
TelephoneNumber: 5708243444
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2015
LastUpdateDate: 05/21/2021
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STREETER
AuthorizedOfficialFirstName: AMANDA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 9049444063
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate: 05/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  N193200000X MULTI-SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
261QR0400X  Y Ambulatory Health Care FacilitiesClinic/CenterRehabilitation

No ID Information.


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