Provider Demographics
NPI:1063699585
Name:FAMILY REHAB SERVICES, INC
Entity type:Organization
Organization Name:FAMILY REHAB SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCCULLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:205-485-2213
Mailing Address - Street 1:902 26TH ST
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-1719
Mailing Address - Country:US
Mailing Address - Phone:205-485-2213
Mailing Address - Fax:205-485-2242
Practice Address - Street 1:902 26TH ST
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-1719
Practice Address - Country:US
Practice Address - Phone:205-485-2213
Practice Address - Fax:205-485-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3646261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALJ887Medicare PIN