Organization Name: | FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC |
NPI Number: | 1043451420 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRUCE J. MACKEY (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 501 Laurel Oak Rd Voorhees |
State: | NJ US |
Postal Code: | 080434418 |
Phone Number: | 8565662340 |
Fax Number: | 8567826513 |
NPI Enumeration Date: | 03/16/2009 |
NPI Last Update Date: | 10/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |