Provider Demographics
NPI:1548460942
Name:SHERIDAN REHABILITATIVE AND WELLNESS CENTERS, INC.
Entity type:Organization
Organization Name:SHERIDAN REHABILITATIVE AND WELLNESS CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-248-6107
Mailing Address - Street 1:919 SHERIDAN ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1128
Mailing Address - Country:US
Mailing Address - Phone:202-248-6107
Mailing Address - Fax:202-315-3540
Practice Address - Street 1:919 SHERIDAN ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1128
Practice Address - Country:US
Practice Address - Phone:202-248-6107
Practice Address - Fax:202-315-3540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness