Healthcare Provider Details

I. General information

NPI: 1508016759
Provider Name (Legal Business Name): MAHAAN REHAB. SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N LINCOLN ST STE H
DIXON CA
95620
US

IV. Provider business mailing address

125 N LINCOLN ST STE H
DIXON CA
95620-3260
US

V. Phone/Fax

Practice location:
  • Phone: 707-718-0151
  • Fax: 707-637-8152
Mailing address:
  • Phone: 707-718-0151
  • Fax: 707-637-8152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: HAAN J ELLING
Title or Position: OWNER
Credential: PT
Phone: 707-718-0151