Provider Demographics
NPI:1871998120
Name:CENTRA OUTPATIENT REHABILITATION SERVICES LLC
Entity type:Organization
Organization Name:CENTRA OUTPATIENT REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBBEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-200-5032
Mailing Address - Street 1:3300 RIVERMONT AVE
Mailing Address - Street 2:ATTN: POST ACUTE FINANCIAL SERVICES NICOLE ROAKES
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2030
Mailing Address - Country:US
Mailing Address - Phone:434-200-6921
Mailing Address - Fax:434-200-3003
Practice Address - Street 1:3300 RIVERMONT AVE
Practice Address - Street 2:ATTN: POST ACUTE FINANCIAL SERVICES NICOLE ROAKES
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2030
Practice Address - Country:US
Practice Address - Phone:434-200-6921
Practice Address - Fax:434-200-3003
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRA HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-29
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1871998120E285Medicare Oscar/Certification