Organization
IMPRESSION HOME HEALTHCARE & THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEGUENE STEPHEN (MANAGING DIRECTOR)
(561) 860-1339
Entity
Organization
Contact information
Practice address
1701 N 14TH ST, FORT PIERCE, FL 34950-2113
(561) 206-2289
Mailing address
6258 WAUCONDA WAY W, LAKE WORTH, FL 33463-5870
(561) 860-1339
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P0010X
Pediatric Rehabilitation Medicine Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
225700000X
Massage Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111802300
—
FL
Enumeration date
07/27/2021
Last updated
08/10/2022
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