Provider Demographics
NPI:1396156196
Name:ATLAS REHABILITATION CENTER LLC
Entity type:Organization
Organization Name:ATLAS REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:D'AMATO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-894-3300
Mailing Address - Street 1:100 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-2405
Mailing Address - Country:US
Mailing Address - Phone:973-894-3300
Mailing Address - Fax:973-894-3299
Practice Address - Street 1:100 MARKET ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-2405
Practice Address - Country:US
Practice Address - Phone:973-894-3300
Practice Address - Fax:973-894-3299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLAS CHIROPRACTIC AND REHABILITATION CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ132159126174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty