Provider Demographics
NPI:1922436476
Name:THERACARE SERVICE & CONSULTING
Entity Type:Organization
Organization Name:THERACARE SERVICE & CONSULTING
Other - Org Name:THERACARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / DIRECTOR REHAB
Authorized Official - Prefix:DR
Authorized Official - First Name:LILY
Authorized Official - Middle Name:N
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:562-600-0138
Mailing Address - Street 1:6351 CANTILES AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5309
Mailing Address - Country:US
Mailing Address - Phone:714-363-8144
Mailing Address - Fax:888-308-0138
Practice Address - Street 1:14611 CARMENITA RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-5228
Practice Address - Country:US
Practice Address - Phone:626-656-5316
Practice Address - Fax:888-308-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-20
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1487963005OtherSHERRA SON OCCUPATIONAL THERAPY
NJ1861548018OtherTAK LAI PHYSICAL THERAPY