Provider Demographics
NPI:1033394507
Name:VALLEY REHABILITATION ASSOCIATES, INC
Entity Type:Organization
Organization Name:VALLEY REHABILITATION ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:KRESL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-502-5361
Mailing Address - Street 1:20940 N TATUM BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4265
Mailing Address - Country:US
Mailing Address - Phone:480-502-5361
Mailing Address - Fax:480-502-5369
Practice Address - Street 1:20940 N TATUM BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4265
Practice Address - Country:US
Practice Address - Phone:480-502-5361
Practice Address - Fax:480-502-5369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6198850001Medicare NSC
AZ120987Medicare PIN