# GL REHABILITATION SERVICES LTD

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

## Provider details

- **NPI number:** 1205880879
- **Authorized official:** MS. ILENE L LARSON PT MS (REHABILITATION AGENCY ADMINISTRATOR)
- **Authorized official phone:** (608) 223-1452

## Contact information

- **Practice address:** 470 GARFIELD AVE, EVANSVILLE, WI 53536-1014
- **Practice address phone:** (608) 882-6557
- **Practice address fax:** (608) 882-6559
- **Mailing address:** 2620 WAUNONA WAY, MADISON, WI 53713-1525
- **Mailing address phone:** (608) 223-1452
- **Mailing address fax:** (608) 223-1459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 07/15/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41814300 | — | WI |