Provider Demographics
NPI:1386721892
Name:HAND & REHABILITATION CENTER, LLC
Entity type:Organization
Organization Name:HAND & REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PELANEK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/CHT
Authorized Official - Phone:304-487-1661
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-0384
Mailing Address - Country:US
Mailing Address - Phone:304-487-1661
Mailing Address - Fax:304-487-1848
Practice Address - Street 1:416 OLD BLUEFIELD RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-8927
Practice Address - Country:US
Practice Address - Phone:304-487-1661
Practice Address - Fax:304-487-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV622225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9440049000Medicaid
WVHA4013051Medicare ID - Type UnspecifiedPROVIDER #