Provider Demographics
NPI:1376391136
Name:AQUA SWIM LLC.
Entity type:Organization
Organization Name:AQUA SWIM LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / DIRECTOR OF AQUA REHAB
Authorized Official - Prefix:
Authorized Official - First Name:CHAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-244-1501
Mailing Address - Street 1:48 BRIDLE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1729
Mailing Address - Country:US
Mailing Address - Phone:845-244-1501
Mailing Address - Fax:
Practice Address - Street 1:48 BRIDLE RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1729
Practice Address - Country:US
Practice Address - Phone:845-244-1501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or Charitable
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care