=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710990288
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHAB & WELLNESS CENTERS OF AMERICA, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1205 GARCES HWY STE 300
-----------------------------------------------------
City | DELANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93215-3639
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-721-0468
-----------------------------------------------------
Fax | 661-721-0537
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 233
-----------------------------------------------------
City | DELANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93216-0233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-721-0468
-----------------------------------------------------
Fax | 661-721-0537
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. THOMAS A. SAVARESE
-----------------------------------------------------
Credential | P.T.
-----------------------------------------------------
Telephone | 661-721-0468
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | PT17997
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------