Provider Demographics
NPI:1427275015
Name:QUALITY REHABILITATION NETWORK INC
Entity type:Organization
Organization Name:QUALITY REHABILITATION NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GLADYSZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:928-726-7900
Mailing Address - Street 1:PO BOX 6956
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-6956
Mailing Address - Country:US
Mailing Address - Phone:928-726-7900
Mailing Address - Fax:928-726-7901
Practice Address - Street 1:1951 W 25TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6925
Practice Address - Country:US
Practice Address - Phone:928-726-7900
Practice Address - Fax:928-726-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ883399OtherGROUP AHCCCS
AZAZ0460060OtherGROUP BLUE CROSS
AZAZ0460060OtherGROUP BLUE CROSS
AZZ70353Medicare PIN