Provider Demographics
NPI:1093145849
Name:DY CARE REHABILITATION THERAPY,INC
Entity Type:Organization
Organization Name:DY CARE REHABILITATION THERAPY,INC
Other - Org Name:OLYMPICARE REHABILITATION THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHAMPA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:213-739-6933
Mailing Address - Street 1:PO BOX 75366
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90075-0366
Mailing Address - Country:US
Mailing Address - Phone:213-739-6933
Mailing Address - Fax:213-739-6939
Practice Address - Street 1:3109 W OLYMPIC BLVD
Practice Address - Street 2:C
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2665
Practice Address - Country:US
Practice Address - Phone:213-739-6933
Practice Address - Fax:213-739-6939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty