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NPI Code Detail

MEDICARE: HIGHLAND HEALTHCARE LLC

MEDICARE: HIGHLAND HEALTHCARE 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
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1982371928
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND HEALTHCARE LLC
Provider Business Mailing Address
First Line : 4635 N 14TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4016
Country : US
Telephone Number : 602-264-9039
Fax Number : 602-264-1017
Provider Business Practice Location Address
First Line : 4635 N 14TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4016
Country : US
Telephone Number : 602-264-9039
Fax Number : 602-264-1017
Authorized Official
Title or Position : TREASURER
Name : SOON BURNAM
Credential :
Telephone Number : 949-540-1249
Provider Enumeration Date : 08/26/2021
Last Update Date : 03/01/2024

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Directions to “HIGHLAND HEALTHCARE LLC ” Practice Location

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