Provider Demographics
NPI:1487252482
Name:ARATA REHAB, LLC
Entity type:Organization
Organization Name:ARATA REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-235-5965
Mailing Address - Street 1:3507 GREENSPRING AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1306
Mailing Address - Country:US
Mailing Address - Phone:707-235-5965
Mailing Address - Fax:
Practice Address - Street 1:3507 GREENSPRING AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1306
Practice Address - Country:US
Practice Address - Phone:707-235-5965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467924795OtherNPI TYPE 1
14077904OtherASHA
MD07894OtherSTATE LICENSE