Basic Information
| Provider Information | |||||||||
| NPI: | 1710249099 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHOENIX REHABILITATION AND HEALTH SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 392573 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152519573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243434060 | ||||||||
| FaxNumber: | 7243434069 | ||||||||
| Practice Location | |||||||||
| Address1: | 2687 MAPLEVALE RD | ||||||||
| Address2: | |||||||||
| City: | BROOKVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 158254755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148492442 | ||||||||
| FaxNumber: | 8148495190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2012 | ||||||||
| LastUpdateDate: | 06/30/2020 | ||||||||
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| AuthorizedOfficialLastName: | STAMPER | ||||||||
| AuthorizedOfficialFirstName: | RACHEL | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF PAYOR RELATIONS | ||||||||
| AuthorizedOfficialTelephone: | 2059997371 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | 225100000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.