SPINAL REHAB GROUP, LLC (NPI# 1497063440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497063440 |
| Entity Type | Organization |
| Organization Name | SPINAL REHAB GROUP, LLC |
| Practice Address |
406 S Huntington Ave Jamaica Plain MA 02130-4814 |
| Practice Telephone | 6175244878 |
| Practice Fax Number | 6175240075 |
| Mailing Telephone | 6175244878 |
| Mailing Fax Number | 6175240075 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |
| Authorized Official Name | DR. GLENN LEE DODES (OWNER) |
| Authorized Official Telephone | 6175244878 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0800X |
Clinic/Center Specialization: Recovery Care |
1871 | MA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SPINAL REHAB GROUP, LLC | 406 So. Huntington Ave.., Jamaica Plain, MA 02130 |
| Street Address |
406 S HUNTINGTON AVE |
| City | JAMAICA PLAIN |
| State | MA |
| Zip Code | 02130-4814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913121 | Virginia Dawn Pratt | Social Worker | Ethos, 555 Amory Street, Jamaica Plain, MA 02130 | 2020-08-19 |
| 1689139917 | Lina Skiba | Speech-Language Pathologist | Thom Child & Family Services, 555 Armory St, Jamaica Plain, MA 02130 | 2019-01-31 |
| 1841775442 | Melissa Rocklen | Social Worker | 30 Germania St Bldg C, Jamaica Plain, MA 02130 | 2018-09-28 |
| 1902389281 | Susan N. Berkman | Social Worker | 111 Perkins St., Apt.120, Jamaica Plain, MA 02130 | 2018-09-12 |
| 1326551912 | Cindy Tromp | Counselor | Arbour Hospital, 49 Robinwood Ave, Jamaica Plain, MA 02130 | 2017-11-06 |
| 1811415128 | Jesse Myles Carmen | Social Worker | 555 Armory Street, Jamaica Plain, MA 02130 | 2017-09-07 |
| 1881119410 | Melanie Suzanne Witman | Counselor | 1125 Centre Street, Boston, MA 02130 | 2017-08-04 |
| 1740702125 | Farah Clermont | Counselor | 3815 Washington St., Jamaica Plain, MA 02130 | 2017-07-07 |
| 1346777554 | Anjalie L Pieres | Counselor | 157 Green Streey, Jamaica Plain, MA 02130 | 2017-05-18 |
| 1316480098 | Caroline Amina Shaw-moss | Counselor | 7 Burr St., Boston, MA 02130 | 2016-11-29 |
| Find all providers in zip 02130 | ||||
| Taxonomy Code | 261QR0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Recovery Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477017143 | Cheryl A Molloy-emerson | Clinic/Center | 157 Green St, Jamaica Plain, MA 02130-2667 | 2019-01-28 |
| City | JAMAICA PLAIN |
| Zip Code | 02130 |
Please comment or provide details below to improve the information on SPINAL REHAB GROUP, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.