Provider Demographics
NPI:1578516472
Name:HEALTHY LIFE THERAPY AND REHAB INC
Entity Type:Organization
Organization Name:HEALTHY LIFE THERAPY AND REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZWICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-916-8989
Mailing Address - Street 1:1860 N PINE ISLAND RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5239
Mailing Address - Country:US
Mailing Address - Phone:954-916-8989
Mailing Address - Fax:954-741-7706
Practice Address - Street 1:1860 N PINE ISLAND ROAD
Practice Address - Street 2:SUITE 111
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5233
Practice Address - Country:US
Practice Address - Phone:954-916-8989
Practice Address - Fax:954-741-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL684501261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684501Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER