# STAFFREHAB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588942882
- **Authorized official:** LATASHA LYNN-DIONYSIUS LARSON OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (320) 293-3205

## Contact information

- **Practice address:** 5000 BIRCH ST, 3000 WEST TOWER, NEWPORT BEACH, CA 92660-2127
- **Practice address phone:** (188) 883-5089
- **Mailing address:** 5000 BIRCH ST, 3000 WEST TOWER, NEWPORT BEACH, CA 92660-2127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 103693 | MN | Yes |

## Other

- **Enumeration date:** 08/03/2011
- **Last updated:** 08/03/2011