MEDICARE: CALDER REHABILITATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1912395062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALDER REHABILITATION LLC

Provider Business Mailing Address
First Line	:	848 N RAINBOW BLVD
Second Line	:	#4106
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1103
Country	:	US
Telephone Number	:
Fax Number	:	702-534-6469

Provider Business Practice Location Address
First Line	:	9049 LITTLE ARROW CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-1182
Country	:	US
Telephone Number	:	702-204-3275
Fax Number	:	702-534-6469

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	CHRISTOPHER PAUL CALDER
Credential	:	DPT
Telephone Number	:	702-204-3275

Provider Enumeration Date	:	12/23/2014
Last Update Date	:	01/18/2016

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