| Organization Name: | MEDICAL TECHNICAL REHABILITATION LLC |
| NPI Number: | 1033487780 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS PLAITANO (CEO) |
| Mailing Address: | 1984 Route 22 Hwy W Blairsville |
| State: | PA US |
| Postal Code: | 157171264 |
| Phone Number: | 7244594884 |
| Fax Number: | 7244594886 |
| NPI Enumeration Date: | 12/09/2011 |
| NPI Last Update Date: | 12/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM2800X |
| License Number: | 327022 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Methadone Clinic |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |