# UPSTATE HOME REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053068536
- **Authorized official:** MR. LOUIS CAMPASANO JR. PT, MS (CEO/OWNER)
- **Authorized official phone:** (732) 575-0438

## Contact information

- **Practice address:** 515 TORRINGTON DR, DUNCAN, SC 29334-8123
- **Practice address phone:** (732) 575-0438
- **Mailing address:** 515 TORRINGTON DR, DUNCAN, SC 29334-8123
- **Mailing address phone:** (732) 575-0438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/04/2022
- **Last updated:** 03/04/2022