Provider Demographics
NPI:1457660052
Name:DANAROSE CORP
Entity Type:Organization
Organization Name:DANAROSE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:760-922-8400
Mailing Address - Street 1:1111 W HOBSONWAY
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-1421
Mailing Address - Country:US
Mailing Address - Phone:760-922-8400
Mailing Address - Fax:760-922-8401
Practice Address - Street 1:1111 W HOBSONWAY
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1421
Practice Address - Country:US
Practice Address - Phone:760-922-8400
Practice Address - Fax:760-922-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty