Provider Demographics
NPI:1407178536
Name:TOUCH LIFE CENTER-GLENDALE, LLC
Entity Type:Organization
Organization Name:TOUCH LIFE CENTER-GLENDALE, LLC
Other - Org Name:TOUCH LIFE CENTER-PLACERVILLE, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-291-6268
Mailing Address - Street 1:450 N BRAND BLVD
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2347
Mailing Address - Country:US
Mailing Address - Phone:818-291-6268
Mailing Address - Fax:866-846-3838
Practice Address - Street 1:450 N BRAND BLVD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2347
Practice Address - Country:US
Practice Address - Phone:818-291-6268
Practice Address - Fax:866-846-3838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOUCH LIFE CENTERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-16
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier