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General NPI Number Information
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NPI Number | 1578795985
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Entity Type | Organization
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Legal Business Name | ACTION REHAB CENTER INC.
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 1650 E 104TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90002-3606
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Country | US
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Telephone | 213-386-6320
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Fax | 213-386-6325
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Provider Business Mailing Address
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Address Line | 3540 WILSHIRE BLVD STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90010-2347
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Country | US
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Telephone | 213-386-6320
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Fax | 213-386-6325
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Authorized Official
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Title or Position | EXECUTIVE PROGRAM DIRECTOR
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Name | CIELLO SANTALARGO
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Credential |
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Telephone | 213-386-6320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | PH-000551A
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License Number State | CA
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