Provider Demographics
NPI:1588761712
Name:ACCESS REHABCARE, LLC
Entity type:Organization
Organization Name:ACCESS REHABCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:PROF
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCUSO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:985-863-7500
Mailing Address - Street 1:64519 HIGHWAY 41
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PEARL RIVER
Mailing Address - State:LA
Mailing Address - Zip Code:70452-3654
Mailing Address - Country:US
Mailing Address - Phone:985-863-7500
Mailing Address - Fax:
Practice Address - Street 1:64519 HIGHWAY 41
Practice Address - Street 2:SUITE 7
Practice Address - City:PEARL RIVER
Practice Address - State:LA
Practice Address - Zip Code:70452-3654
Practice Address - Country:US
Practice Address - Phone:985-863-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT00163R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty