Provider Demographics
NPI:1215273339
Name:COMMUNITY REHAB, INC
Entity type:Organization
Organization Name:COMMUNITY REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:THEILER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:402-721-3908
Mailing Address - Street 1:119 N 51ST ST
Mailing Address - Street 2:#101
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-2867
Mailing Address - Country:US
Mailing Address - Phone:402-506-5695
Mailing Address - Fax:402-506-6758
Practice Address - Street 1:6001 DODGE ST
Practice Address - Street 2:FH 026
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68182-1102
Practice Address - Country:US
Practice Address - Phone:402-554-3112
Practice Address - Fax:402-554-3381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy