Provider Demographics
NPI:1124163365
Name:BRISTOL COUNTY REHABILITATION SERVICES
Entity type:Organization
Organization Name:BRISTOL COUNTY REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLOUGH-ALMEIDA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:401-578-8369
Mailing Address - Street 1:1341 WEST MAIN ROAD SUITE 12
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842
Mailing Address - Country:US
Mailing Address - Phone:401-578-8369
Mailing Address - Fax:401-619-1988
Practice Address - Street 1:1341 WEST MAIN ROAD SUITE 12
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842
Practice Address - Country:US
Practice Address - Phone:401-578-8369
Practice Address - Fax:401-619-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI332224Z00000X
RI272224Z00000X
RI398224Z00000X
RI400224Z00000X
RI450224Z00000X
RI240224Z00000X
RI2244225100000X
RI72225200000X
RI839225200000X
RI879225X00000X
RI1272225X00000X
RI443225X00000X
RI144225X00000X
RI279225XP0200X
RI8472251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty