Basic Information
| Provider Information | |||||||||
| NPI: | 1134253859 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTA CLARITA VALLEY THERAPY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25129 THE OLD RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | STEVENSON RANCH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913812281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612841984 | ||||||||
| FaxNumber: | 6612841991 | ||||||||
| Practice Location | |||||||||
| Address1: | 25129 THE OLD RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | STEVENSON RANCH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913812281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612841984 | ||||||||
| FaxNumber: | 6612841991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | GRIS | ||||||||
| AuthorizedOfficialFirstName: | ELIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6612841984 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.