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Organization
NEW AGE ENTERPRISES
Active
Organization
NEW AGE ENTERPRISES
Active
Other names
Manale Occupational & Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VALERIE M MENDOZA REGIONAL MANAGER/HR (REGIONAL MANAGER/HR)
(562) 927-5820
Entity
Organization
Contact information
Practice address
7320 FIRESTONE BLVD STE 105, DOWNEY, CA 90241-4159
(562) 927-5820
(562) 684-0102
Mailing address
817 W BEVERLY BLVD STE 201, MONTEBELLO, CA 90640-4265
(562) 927-5820
(562) 684-0102
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
225X00000X
Occupational Therapist
Primary
OT 4566
CA
261QP2000X
Physical Therapy Clinic/Center
OT 4566
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
521108
—
CA
Enumeration date
01/06/2012
Last updated
11/16/2020
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