Provider Demographics
NPI:1679095483
Name:THE HUNTSVILLE REHABILITATION FOUNDATION, INC.
Entity type:Organization
Organization Name:THE HUNTSVILLE REHABILITATION FOUNDATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MAS
Authorized Official - Phone:256-319-7872
Mailing Address - Street 1:2939 JOHNSON RD SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-5844
Mailing Address - Country:US
Mailing Address - Phone:256-880-0680
Mailing Address - Fax:256-880-2149
Practice Address - Street 1:2939 JOHNSON RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-5844
Practice Address - Country:US
Practice Address - Phone:256-880-0680
Practice Address - Fax:256-880-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)