Healthcare Provider Details

I. General information

NPI: 1750687224
Provider Name (Legal Business Name): SALUS THERAPIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19600 FAIRCHILD STE 290
IRVINE CA
92612-2504
US

IV. Provider business mailing address

19600 FAIRCHILD STE 290
IRVINE CA
92612-2504
US

V. Phone/Fax

Practice location:
  • Phone: 949-208-3399
  • Fax: 949-208-3392
Mailing address:
  • Phone: 858-735-4933
  • Fax: 949-208-3392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY P KELLEY
Title or Position: CEO
Credential:
Phone: 858-735-4933