Provider Demographics
NPI:1386923928
Name:AT HOME REHAB & CONSULTING SERVICES, LLC.
Entity type:Organization
Organization Name:AT HOME REHAB & CONSULTING SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/ CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRYDOM
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CAPS
Authorized Official - Phone:413-822-1427
Mailing Address - Street 1:96 HARRYEL ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4420
Mailing Address - Country:US
Mailing Address - Phone:413-464-0093
Mailing Address - Fax:
Practice Address - Street 1:96 HARRYEL ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4420
Practice Address - Country:US
Practice Address - Phone:413-464-0093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-14
Last Update Date:2011-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4237225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty