Provider Demographics
NPI:1497737522
Name:NEW WEST REHABILITATION, INC.
Entity Type:Organization
Organization Name:NEW WEST REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:714-542-6646
Mailing Address - Street 1:11100 WARNER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7512
Mailing Address - Country:US
Mailing Address - Phone:714-542-6646
Mailing Address - Fax:714-542-6656
Practice Address - Street 1:11180 WARNER AVE
Practice Address - Street 2:SUITE 155
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708
Practice Address - Country:US
Practice Address - Phone:714-542-6646
Practice Address - Fax:714-542-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGPT0000540Medicaid
CAW14704Medicare ID - Type Unspecified