Provider Demographics
NPI:1568239572
Name:LIFE AND FAMILY REHABILITATION
Entity Type:Organization
Organization Name:LIFE AND FAMILY REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZAHNER
Authorized Official - Suffix:III
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:208-403-2062
Mailing Address - Street 1:5470 FLAG WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2499
Mailing Address - Country:US
Mailing Address - Phone:208-403-2062
Mailing Address - Fax:
Practice Address - Street 1:150 MORNING SUN DR STE 100
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-9160
Practice Address - Country:US
Practice Address - Phone:719-602-5503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No251V00000XAgenciesVoluntary or Charitable
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service