At Home Rehab LLC

Organization Active NPI Orthopedic Physical Therapist · Salida, CO

NPI 1871548750 · NPPES record last updated Aug 15, 2007

Key facts

NPI
1871548750
Entity type
Organization (NPI type 2)
Primary specialty
Orthopedic Physical Therapist 2251X0800X
License
6910 (CO)
Legal business name
AT HOME REHAB LLC
Practice address
731 Blake St
Salida, CO 81201-2919
Phone
(719) 539-2431
Fax
(719) 539-3626
NPI assigned
May 22, 2006
Organization subpart
No

Authorized official

Name
Ms. Leanora Theresa Premeau, M.P.T.
Title
Physical Therapist
Phone
(719) 539-2431

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050816000382 CO Part B Supplier - Clinic/Group Practice 0749210128 Receives reassigned benefits from 1 practitioner
Practice locations: Salida, CO

National Provider Directory

Locations

731 Blake St
Salida, CO 81201
Phone (719) 539-2431

735 Blake St
Ste 102
Salida, CO 81201
Phone (719) 207-0187

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
2251X0800X 6910 CO Yes

Addresses

Primary practice location

731 Blake St
Salida, CO 81201-2919

Mailing address

416 E 4TH St
Salida, CO 81201-2822
Phone (719) 539-2431

Other providers in Salida, CO

All providers in Salida, CO · Orthopedic Physical Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.