Healthcare Provider Details

I. General information

NPI: 1467386433
Provider Name (Legal Business Name): WSSH POWERBACK REHABILITATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 BERNARDSVILLE RD
MENDHAM NJ
07945-2923
US

IV. Provider business mailing address

9526 W PICO BLVD
LOS ANGELES CA
90035-1202
US

V. Phone/Fax

Practice location:
  • Phone: 323-928-9445
  • Fax:
Mailing address:
  • Phone: 310-730-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AVROHOM TRESS
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 323-928-9445