Healthcare Provider Details
I. General information
NPI: 1932555976
Provider Name (Legal Business Name): PREMIERE REHABILITATION & WELLNESS CENTER OF LANCASTER LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2016
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
43830 10TH ST W
LANCASTER CA
93534-4826
US
IV. Provider business mailing address
400 EXCHANGE SUITE 140
IRVINE CA
92602-1340
US
V. Phone/Fax
- Phone: 661-494-8600
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SHLOMO
RECHNITZ
Title or Position: MANAGING MEMBER
Credential:
Phone: 626-800-1191