# SOUTH PACIFIC REHABILITATION SERVISEC

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

## Provider details

- **NPI number:** 1891148201
- **Authorized official:** TERESA FERN FARAG AA DEGREE (OTA/L)
- **Authorized official phone:** (818) 274-7478

## Contact information

- **Practice address:** 10469 LARWIN AVE UNIT 4, CHATSWORTH, CA 91311-0314
- **Practice address phone:** (818) 274-7478
- **Mailing address:** 10469 LARWIN AVE 4, CHATSWORTH, CA 91311
- **Mailing address phone:** (818) 274-7478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 224200000 | CA | Yes |

## Other

- **Enumeration date:** 07/20/2016
- **Last updated:** 07/20/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 224200000 | — | CA |