Organization Name: | MATRIX REHABILITATION, INC. |
NPI Number: | 1306872163 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL E. TARVIN (VICE PRESIDENT) |
Mailing Address: | 41945 Big Bear Boulevard Suite 209 Big Bear Lake |
State: | CA US |
Postal Code: | 923159998 |
Phone Number: | 9098666200 |
Fax Number: | 9098666111 |
NPI Enumeration Date: | 06/24/2006 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |