On Track Rehabilitation, LLC
Clinic/Center, Health Services in Essex, MD. Organization (NPI-2).
NPI number1588053227
StatusActive
Last updated in NPPESJan 19, 2015
Details
- NPI
- 1588053227
- Entity type
- Organization (NPI-2)
- Legal business name
- On Track Rehabilitation, LLC
- Organization subpart
- No
- Enumeration date
- Jan 19, 2015
- Last updated
- Jan 19, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | 20878 | MD | Yes |
| 251E00000X | Home Health | 20878 | MD |
Practice location
8839 Kelso DrEssex, MD 21221-3141
Phone 443-415-0004
Mailing address
3702 Brenbrook DrRandallstown, MD 21133-4116
Phone 443-415-0004
Authorized official
Erin Latreace Logan
Owner
4434150004
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