Provider Demographics
NPI:1659756450
Name:REHAB ALLIANCE
Entity Type:Organization
Organization Name:REHAB ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-707-5555
Mailing Address - Street 1:22995 MILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1215
Mailing Address - Country:US
Mailing Address - Phone:949-707-5555
Mailing Address - Fax:949-707-5706
Practice Address - Street 1:1720 MT VIEW AVE
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-1727
Practice Address - Country:US
Practice Address - Phone:909-796-6915
Practice Address - Fax:909-799-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT5709273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit