Travco Rehabilitation Center, Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

License

364511 Issued in OH

Legal business name

TRAVCO REHABILITATION CENTER, INC.

Practice address

4030 Boardman Canfield Rd
Suite 200C
Canfield, OH 44406-9505

Phone

(330) 286-0050

Fax

(330) 286-0055

NPI assigned

Aug 24, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Scott Thomas Gorley

Title

President

Phone

(330) 286-0050

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881687085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 BOARDMAN CANFIELD RD",
            "address_2": "SUITE 200C",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069505",
            "telephone_number": "330-286-0050",
            "fax_number": "330-286-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 BOARDMAN CANFIELD RD",
            "address_2": "SUITE 200C",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069505",
            "telephone_number": "330-286-0050",
            "fax_number": "330-286-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVCO REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORLEY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-286-0050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "OH",
            "license": "364511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2143620",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Canfield, OH
• Providers in Canfield, OH by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.