Provider Demographics
NPI:1568546711
Name:UNITED THERAPY NETWORK
Entity Type:Organization
Organization Name:UNITED THERAPY NETWORK
Other - Org Name:RANCHO SPECIALTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CIVILLANI
Authorized Official - Middle Name:DELAPENA
Authorized Official - Last Name:LAYOS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:909-641-1885
Mailing Address - Street 1:15362 GARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-4015
Mailing Address - Country:US
Mailing Address - Phone:909-574-6192
Mailing Address - Fax:
Practice Address - Street 1:10841 WHITE OAK AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3811
Practice Address - Country:US
Practice Address - Phone:909-948-0411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28911283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital