Provider Demographics
NPI:1063742781
Name:CHRIS'S REHABALITIATIVE SERVICES
Entity type:Organization
Organization Name:CHRIS'S REHABALITIATIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EVERETTE
Authorized Official - Middle Name:LEVON
Authorized Official - Last Name:WITHERSPOON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-306-4815
Mailing Address - Street 1:PO BOX 5196
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27435-0196
Mailing Address - Country:US
Mailing Address - Phone:336-617-3236
Mailing Address - Fax:336-617-5869
Practice Address - Street 1:2303 W MEADOWVIEW RD
Practice Address - Street 2:SUTE 11
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3726
Practice Address - Country:US
Practice Address - Phone:336-617-3236
Practice Address - Fax:336-617-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health