Provider Demographics
NPI:1194540336
Name:RE-BOUND-IT INC.
Entity type:Organization
Organization Name:RE-BOUND-IT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTIVE
Authorized Official - Prefix:
Authorized Official - First Name:DONETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-327-8888
Mailing Address - Street 1:417 E BLACK ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5341
Mailing Address - Country:US
Mailing Address - Phone:803-327-8888
Mailing Address - Fax:
Practice Address - Street 1:417 E BLACK ST STE 106
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5341
Practice Address - Country:US
Practice Address - Phone:803-327-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management