Provider Demographics
NPI:1720246176
Name:NEURO REHAB PARTNERS LLC
Entity Type:Organization
Organization Name:NEURO REHAB PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HERLENE
Authorized Official - Middle Name:LEW
Authorized Official - Last Name:MCLEES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:310-370-2201
Mailing Address - Street 1:6133 BRISTOL PKWY
Mailing Address - Street 2:SUITE #200
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6609
Mailing Address - Country:US
Mailing Address - Phone:310-337-7600
Mailing Address - Fax:310-337-7607
Practice Address - Street 1:6133 BRISTOL PKWY
Practice Address - Street 2:SUITE #200
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6609
Practice Address - Country:US
Practice Address - Phone:310-337-7600
Practice Address - Fax:310-337-7607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-31
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAS545Medicare UPIN