Provider Demographics
NPI:1730235953
Name:ARIZONA REHABILITATION ASSOCIATES, LTD
Entity type:Organization
Organization Name:ARIZONA REHABILITATION ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:HOLDEMAN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT ,CHT
Authorized Official - Phone:602-363-3665
Mailing Address - Street 1:5620 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE G 3
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4636
Mailing Address - Country:US
Mailing Address - Phone:602-843-4322
Mailing Address - Fax:602-283-0897
Practice Address - Street 1:5620 W THUNDERBIRD RD
Practice Address - Street 2:SUITE G 3
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4636
Practice Address - Country:US
Practice Address - Phone:602-938-2422
Practice Address - Fax:602-938-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ036555Medicare Oscar/Certification