Provider Demographics
NPI:1912493750
Name:PRIOR LEVEL HOME CARE PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:PRIOR LEVEL HOME CARE PHYSICAL THERAPY INC.
Other - Org Name:PRIOR LEVEL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MCCLINTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-215-2547
Mailing Address - Street 1:1200 CALIFORNIA ST STE 112
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2946
Mailing Address - Country:US
Mailing Address - Phone:909-312-7099
Mailing Address - Fax:909-312-7809
Practice Address - Street 1:1200 CALIFORNIA ST STE 112
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2946
Practice Address - Country:US
Practice Address - Phone:909-312-7099
Practice Address - Fax:909-312-7809
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIOR LEVEL HOME CARE PHYSICAL THERAPY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health