Basic Information
| Provider Information | |||||||||
| NPI: | 1427107945 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | H2 REHABILITATION SERVICES OF VIRGINIA LLC | ||||||||
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| OtherOrganizationName: | H2 HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 554 KINGSLEY AVE | ||||||||
| Address2: | |||||||||
| City: | ORANGE PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320734830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9049444063 | ||||||||
| FaxNumber: | 9049444063 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E MAIN ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | WYTHEVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243823311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2762286200 | ||||||||
| FaxNumber: | 2762289175 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 05/29/2020 | ||||||||
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| AuthorizedOfficialLastName: | STREETER | ||||||||
| AuthorizedOfficialFirstName: | AMANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9049444063 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.