Provider Demographics
NPI:1154513695
Name:EXCELLENCE IN REHABILITATION INC
Entity type:Organization
Organization Name:EXCELLENCE IN REHABILITATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMANN-WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA,OTR, CHT
Authorized Official - Phone:317-582-1556
Mailing Address - Street 1:9449 PRIORITY WAY WEST DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-6425
Mailing Address - Country:US
Mailing Address - Phone:317-582-1556
Mailing Address - Fax:317-582-1559
Practice Address - Street 1:9449 PRIORITY WAY WEST DR
Practice Address - Street 2:SUITE 118
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-6425
Practice Address - Country:US
Practice Address - Phone:317-582-1556
Practice Address - Fax:317-582-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1972684918261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0324030002Medicare NSC