Provider Demographics
NPI:1215361936
Name:REBOUND HAWAII LLC
Entity type:Organization
Organization Name:REBOUND HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENELYN
Authorized Official - Middle Name:P
Authorized Official - Last Name:OKUMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-674-9998
Mailing Address - Street 1:338 KAMOKILA BLVD
Mailing Address - Street 2:#201
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2055
Mailing Address - Country:US
Mailing Address - Phone:808-674-9998
Mailing Address - Fax:808-674-9877
Practice Address - Street 1:338 KAMOKILA BLVD
Practice Address - Street 2:#201
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2055
Practice Address - Country:US
Practice Address - Phone:808-674-9998
Practice Address - Fax:808-674-9877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty