# ADVANCED REHABILITATION SERVICE

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

## Provider details

- **NPI number:** 1316977085
- **Authorized official:** MISS DANIELLE LYNN THIESEN (CEO)
- **Authorized official phone:** (505) 299-2521

## Contact information

- **Practice address:** 4001 JUAN TABO BLVD NE STE B, ALBUQUERQUE, NM 87111-3979
- **Practice address phone:** (505) 299-2521
- **Practice address fax:** (505) 298-8899
- **Mailing address:** 4001 JUAN TABO PLACE NE SUITE B, ALBUQUERQNE, NM 87111
- **Mailing address phone:** (505) 299-2521
- **Mailing address fax:** (505) 298-8899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | IT3229 | NM | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 07/29/2008