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General NPI Number Information
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NPI Number | 1306400205
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Entity Type | Organization
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Legal Business Name | PROSTAR REHABILITATION SERVICES, LLC
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 9171 WILSHIRE BLVD STE 500
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5536
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Country | US
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Telephone | 305-343-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 9171 WILSHIRE BLVD STE 500
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5536
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Country | US
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Telephone | 305-343-1211
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Fax |
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Authorized Official
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Title or Position | OTA/L, ADMINISTRATOR
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Name | ALEXANDER JULIAN ARIAS
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Credential | BSHA
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Telephone | 305-343-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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