Provider Demographics
NPI:1003505041
Name:INTEGRATED REHABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:INTEGRATED REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAWANKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:323-344-2630
Mailing Address - Street 1:2929 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-3611
Mailing Address - Country:US
Mailing Address - Phone:323-344-2630
Mailing Address - Fax:
Practice Address - Street 1:2929 WELLINGTON RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-3611
Practice Address - Country:US
Practice Address - Phone:323-344-2630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty