Provider Demographics
NPI:1437572369
Name:HEARING REHAB CENTER WEST HILLS LLC
Entity Type:Organization
Organization Name:HEARING REHAB CENTER WEST HILLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILKEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:303-984-4414
Mailing Address - Street 1:8321 SANGRE DE CRISTO RD
Mailing Address - Street 2:STE 202
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6425
Mailing Address - Country:US
Mailing Address - Phone:303-984-4414
Mailing Address - Fax:303-984-6244
Practice Address - Street 1:5440 SW WESTGATE DR
Practice Address - Street 2:STE 350
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2447
Practice Address - Country:US
Practice Address - Phone:503-292-1100
Practice Address - Fax:503-292-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty