Healthcare Provider Details

I. General information

NPI: 1013940634
Provider Name (Legal Business Name): ELITE REHABILITATION CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5152 HOLLISTER AVE
SANTA BARBARA CA
93111-2526
US

IV. Provider business mailing address

5152 HOLLISTER AVE
SANTA BARBARA CA
93111-2526
US

V. Phone/Fax

Practice location:
  • Phone: 805-681-9108
  • Fax: 805-681-9208
Mailing address:
  • Phone: 805-681-9108
  • Fax: 805-681-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ALAN SWAN
Title or Position: PRINCIPAL
Credential: MPT
Phone: 805-681-9108