Five Star Rehabilitation and Wellness Services, LLC.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.

Doing business as

Ageility Physical Therapy Solutions at Riviera

Practice address

1825 Ridgewood Ave
Holly Hill, FL 32117-1737

Phone

(386) 677-5000

NPI assigned

Sep 24, 2012

Last updated

Oct 20, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey C Leer

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other names 1

• Ageility Physical Therapy Solutions at Riviera Doing business as

Part of

Five Star Rehabilitation and Wellness Services LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1063763621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 230",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581644",
            "telephone_number": "617-796-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 RIDGEWOOD AVE",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321171737",
            "telephone_number": "386-677-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "enumeration_date": "2012-09-24",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "LEER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageility Physical Therapy Solutions at Riviera",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ageility Physical Therapy Solutions at Riviera",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Faithful Caregivers,LLC
• Family Medical Practice Management, Inc.
• John Nicholas Fedorovich, R.PH.
• Christina Fendelander, RPH
• Cynthia Stephens Fisher, MSW
• Florehab, Inc.
• Florida Health Care Plan Inc (Florida Health Care Plans Pharmacy Mail)
• Florida Health Care Plan, Inc. (Florida Health Care Plans Pharmacy-Holly Hill)
• Kristen Foli, PHARMD
• Kyla Denise Fraley, LMT

• Physical Therapy Clinic/Center in Holly Hill, FL
• Providers in Holly Hill, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.