Provider Demographics
NPI:1306050240
Name:CROUSE REHAB ASSOCIATES, INC.
Entity type:Organization
Organization Name:CROUSE REHAB ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JERI
Authorized Official - Middle Name:GATES
Authorized Official - Last Name:CROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:404-256-5655
Mailing Address - Street 1:6065 ROSWELL RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4011
Mailing Address - Country:US
Mailing Address - Phone:404-256-5655
Mailing Address - Fax:404-256-1720
Practice Address - Street 1:6065 ROSWELL RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4011
Practice Address - Country:US
Practice Address - Phone:404-256-5655
Practice Address - Fax:404-256-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GRP6731Medicare ID - Type Unspecified