Provider Demographics
NPI:1235868381
Name:REHAB SPECIALISTS OUTPATIENT LLC
Entity Type:Organization
Organization Name:REHAB SPECIALISTS OUTPATIENT LLC
Other - Org Name:AGESTRONG PARADISE VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:TONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-206-5125
Mailing Address - Street 1:2700 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3006
Mailing Address - Country:US
Mailing Address - Phone:619-475-5040
Mailing Address - Fax:
Practice Address - Street 1:2700 E 4TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3006
Practice Address - Country:US
Practice Address - Phone:619-475-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation