Provider Demographics
NPI:1861663247
Name:81 GRAND HOLDINGS INC
Entity Type:Organization
Organization Name:81 GRAND HOLDINGS INC
Other - Org Name:CALIFORNIA REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:J
Authorized Official - Last Name:STECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:209-578-3290
Mailing Address - Street 1:1539 MCHENRY AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4528
Mailing Address - Country:US
Mailing Address - Phone:209-578-3290
Mailing Address - Fax:209-550-4944
Practice Address - Street 1:1539 MCHENRY AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4528
Practice Address - Country:US
Practice Address - Phone:209-578-3290
Practice Address - Fax:209-550-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty