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General NPI Number Information
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NPI Number | 1184786089
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Entity Type | Organization
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Legal Business Name | INNOVATIVE SENIOR REHABILITATION SERVICES INC.
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 311 W TURNER RD
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City | LODI
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State | CA
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Zip | 95240-0517
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Country | US
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Telephone | 209-367-5812
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Fax | 209-367-5812
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Provider Business Mailing Address
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Address Line | 8147 LAKESPRING WAY
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City | SACRAMENTO
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State | CA
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Zip | 95828-6354
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Country | US
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Telephone | 916-690-0757
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Fax | 916-714-9963
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Authorized Official
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Title or Position | VP CFO
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Name | ELIZABETH JOY HADLEY
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Credential |
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Telephone | 916-690-0757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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