Extend Rehab LLC
Occupational Therapist in Bethel, CT. Organization (NPI-2).
NPI number1144707274
StatusActive
Last updated in NPPESFeb 26, 2019
Details
- NPI
- 1144707274
- Entity type
- Organization (NPI-2)
- Legal business name
- Extend Rehab LLC
- Organization subpart
- No
- Enumeration date
- Jul 21, 2018
- Last updated
- Feb 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | – | CT | Yes |
| 225100000X | Physical Therapist | – | CT |
Practice location
121 Codfish Hill RdBethel, CT 06801-3203
Phone 475-279-0347
Mailing address
121 Codfish Hill RdBethel, CT 06801-3203
Phone 475-279-0347
Authorized official
Stephen Suriano
Manager
4752790838
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