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General NPI Number Information
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NPI Number | 1215950621
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Entity Type | Organization
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Legal Business Name | GH MAP INC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 1902 B ST STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93301-3526
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Country | US
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Telephone | 661-637-1111
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Fax | 661-637-1112
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Provider Business Mailing Address
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Address Line | 1902 B ST SUITE B G H MAP INC DBA LIFE LINE THERAPY
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City | BAKERSFIELD
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State | CA
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Zip | 93301
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Country | US
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Telephone | 661-637-1111
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Fax | 661-637-1112
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MELISSA ANN CHANG
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Credential |
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Telephone | 661-637-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | 120000665
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License Number State | CA
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