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General NPI Number Information
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NPI Number | 1912493750
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Entity Type | Organization
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Legal Business Name | PRIOR LEVEL HOME CARE PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 1200 CALIFORNIA ST STE 112
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City | REDLANDS
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State | CA
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Zip | 92374-2946
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Country | US
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Telephone | 909-312-7099
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Fax | 909-312-7809
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Provider Business Mailing Address
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Address Line | 1200 CALIFORNIA ST STE 112
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City | REDLANDS
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State | CA
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Zip | 92374-2946
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Country | US
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Telephone | 909-312-7099
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Fax | 909-312-7809
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Authorized Official
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Title or Position | CEO/OWNER/ADMINISTRATOR
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Name | MRS. ALISON RAE MCCLINTOCK
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Credential | PT
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Telephone | 805-215-2547
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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 | CA
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