Provider Demographics
NPI:1356659742
Name:HOLLYWOOD HANDS REHABILITATION INC
Entity Type:Organization
Organization Name:HOLLYWOOD HANDS REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:OT, CHT
Authorized Official - Phone:310-968-0602
Mailing Address - Street 1:1441 S BEVERLY GLEN BLVD
Mailing Address - Street 2:#213
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6162
Mailing Address - Country:US
Mailing Address - Phone:310-968-0602
Mailing Address - Fax:
Practice Address - Street 1:8600 W 3RD ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3338
Practice Address - Country:US
Practice Address - Phone:310-968-0602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 2313225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty