Provider Demographics
NPI:1093849754
Name:LIFE ENHANCING THERAPIES
Entity Type:Organization
Organization Name:LIFE ENHANCING THERAPIES
Other - Org Name:INLAND EMPIRE THERAPY PROVIDERS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KRUPNAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-481-5304
Mailing Address - Street 1:7974 HAVEN AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3061
Mailing Address - Country:US
Mailing Address - Phone:909-481-5304
Mailing Address - Fax:909-481-5307
Practice Address - Street 1:7974 HAVEN AVE STE 290
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3061
Practice Address - Country:US
Practice Address - Phone:909-481-5304
Practice Address - Fax:909-481-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty