Provider Demographics
NPI:1841622396
Name:ADVENTIST REHABILITATION, INC.
Entity type:Organization
Organization Name:ADVENTIST REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-315-3030
Mailing Address - Street 1:820 W DIAMOND AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1469
Mailing Address - Country:US
Mailing Address - Phone:301-315-3102
Mailing Address - Fax:
Practice Address - Street 1:12041 BOURNEFIELD WAY STE B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7908
Practice Address - Country:US
Practice Address - Phone:301-592-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No273Y00000XHospital UnitsRehabilitation Unit