Provider Demographics
NPI:1336443878
Name:AT HOME REHAB AND NURSING INC,
Entity type:Organization
Organization Name:AT HOME REHAB AND NURSING INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:OLVIS
Authorized Official - Last Name:MONDANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-736-6807
Mailing Address - Street 1:3328 OAKLYN DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-7313
Mailing Address - Country:US
Mailing Address - Phone:414-736-6807
Mailing Address - Fax:
Practice Address - Street 1:3328 OAKLYN DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-7313
Practice Address - Country:US
Practice Address - Phone:414-736-6807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-25
Last Update Date:2010-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty