Impact Rehabilitation Center Inc

LBN: Impact Rehabilitation Center Inc
Impact Rehabilitation Center Inc is an health care organization with primary practice located at 255 N Tustin St , Orange CA 92867-7772. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Impact Rehabilitation Center Inc can be contacted via phone (714) 288-9125, or through Sutcliff, Willis Mark via phone (714) 288-9125.

Contact Information

Primary practice address
255 N Tustin St Orange CA 92867-7772
Phone: (714) 288-9125
Fax: (714) 288-9129
Website:
Map and Directions
Authorized official contact:
Name: Sutcliff, Willis Mark MPT, ATC
Phone: (714) 288-9125

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X PT26858 California

Profile Details

NPI number 1801817739
LBN Legal business name Impact Rehabilitation Center Inc
DBA Doing business as
Authorized official Sutcliff, Willis Mark MPT, ATC
Entity Organization
Organization subpart 1 No
Enumeration date Jul 23rd, 2006
Last updated Mar 30th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801817739 NPPES
California MEDICAID GPT001400

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