| Organization Name: | BOOST REHAB |
| NPI Number: | 1760892699 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN J BIANCHINI (MEMBER) |
| Mailing Address: | 2901 N I 10 Service Rd E Ste 201 Metairie |
| State: | LA US |
| Postal Code: | 700026137 |
| Phone Number: | 5047801702 |
| Fax Number: | 5047801705 |
| NPI Enumeration Date: | 04/30/2014 |
| NPI Last Update Date: | 04/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Rehabilitation Practitioner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |