Provider Demographics
NPI: | 1053409367 |
---|---|
Name: | CAROLINA REHABILITATION SPECIALISTS, INC. |
Entity type: | Organization |
Organization Name: | CAROLINA REHABILITATION SPECIALISTS, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT/OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | SUMMER |
Authorized Official - Middle Name: | VASSEY |
Authorized Official - Last Name: | MCMURRY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS, CCC-SLP |
Authorized Official - Phone: | 828-670-8056 |
Mailing Address - Street 1: | 9 W SUMMIT AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | ASHEVILLE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28803-0047 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 828-670-8056 |
Mailing Address - Fax: | 828-670-8057 |
Practice Address - Street 1: | 9 W SUMMIT AVE |
Practice Address - Street 2: | |
Practice Address - City: | ASHEVILLE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28803-0047 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-670-8056 |
Practice Address - Fax: | 828-670-8057 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-11 |
Last Update Date: | 2019-09-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty | |
No | 237700000X | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | Group - Multi-Specialty | |
No | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 6006298 | Medicaid | |
NC | 8300021 | Medicaid | |
NC | 8300021K | Medicaid | |
NC | 015W0 | Other | BCBSNC |
NC | 7211431 | Medicaid |