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General NPI Number Information
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NPI Number | 1144639980
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Entity Type | Organization
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Legal Business Name | NEURO REHAB CONNECTION
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 31309 TEMECULA PKWY STE 101
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City | TEMECULA
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State | CA
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Zip | 92592-6826
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Country | US
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Telephone | 951-595-3268
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Fax | 951-266-5759
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Provider Business Mailing Address
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Address Line | 33175 TEMECULA PKWY # A-124
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City | TEMECULA
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State | CA
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Zip | 92592-7310
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Country | US
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Telephone | 951-595-3268
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Fax | 951-266-5759
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES DAVIS
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Credential | OTRL
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Telephone | 480-789-2980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | OT13729
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License Number State | CA
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