Provider Demographics
NPI:1285958116
Name:PROSTEP REHAB
Entity type:Organization
Organization Name:PROSTEP REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY REHAB COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAMELLIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:606-678-5104
Mailing Address - Street 1:200 NORFLEET DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1952
Mailing Address - Country:US
Mailing Address - Phone:606-678-5104
Mailing Address - Fax:606-677-1925
Practice Address - Street 1:200 NORFLEET DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1952
Practice Address - Country:US
Practice Address - Phone:606-678-5104
Practice Address - Fax:606-677-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA02524314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility