Healthcare Provider Details

I. General information

NPI: 1073272456
Provider Name (Legal Business Name): TRANSFORMATION REHAB AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 02/27/2022
Certification Date: 02/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13275 SUNSTREAM DR
CHINO HILLS CA
91709-3593
US

IV. Provider business mailing address

13275 SUNSTREAM DR
CHINO HILLS CA
91709-3593
US

V. Phone/Fax

Practice location:
  • Phone: 562-380-0939
  • Fax:
Mailing address:
  • Phone: 562-380-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MYRIAN ELIZABETH MELNECHUK
Title or Position: CEO/OWNER
Credential: OT
Phone: 562-380-0939