Provider Demographics
NPI:1588697932
Name:WINDWARD REHABILITATION SERVICES, LLC
Entity type:Organization
Organization Name:WINDWARD REHABILITATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:808-261-9792
Mailing Address - Street 1:26 HOOLAI ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-6108
Mailing Address - Country:US
Mailing Address - Phone:808-261-9792
Mailing Address - Fax:808-262-8600
Practice Address - Street 1:26 HOOLAI ST
Practice Address - Street 2:SUITE 200
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-6108
Practice Address - Country:US
Practice Address - Phone:808-261-9792
Practice Address - Fax:808-262-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI6457860001Medicare NSC
HIH54518Medicare PIN