Organization
SOUTH PACIFIC REHABILITATION SERVISEC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA FERN FARAG AA DEGREE (OTA/L)
(818) 274-7478
Entity
Organization
Contact information
Practice address
10469 LARWIN AVE UNIT 4, CHATSWORTH, CA 91311-0314
(818) 274-7478
Mailing address
10469 LARWIN AVE 4, CHATSWORTH, CA 91311
(818) 274-7478
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
224200000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224200000
—
CA
Enumeration date
07/20/2016
Last updated
07/20/2016
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