Provider Demographics
NPI:1285676569
Name:SAIJ, LLC
Entity Type:Organization
Organization Name:SAIJ, LLC
Other - Org Name:OPT REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DURKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-802-7081
Mailing Address - Street 1:10325 E RIGGS RD
Mailing Address - Street 2:#102
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-7623
Mailing Address - Country:US
Mailing Address - Phone:480-802-7081
Mailing Address - Fax:480-802-8492
Practice Address - Street 1:10325 E RIGGS RD
Practice Address - Street 2:#102
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-7623
Practice Address - Country:US
Practice Address - Phone:480-802-7081
Practice Address - Fax:480-802-9492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC3123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ133282Medicare PIN
AZDQ5671Medicare PIN