Provider Demographics
NPI:1396143418
Name:THE LEARNING GROVE PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:THE LEARNING GROVE PHYSICAL THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:LINARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-800-4332
Mailing Address - Street 1:18631 SHERMAN WAY
Mailing Address - Street 2:SUITE D
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4193
Mailing Address - Country:US
Mailing Address - Phone:818-399-9199
Mailing Address - Fax:818-343-4713
Practice Address - Street 1:18631 SHERMAN WAY
Practice Address - Street 2:SUITE D
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4193
Practice Address - Country:US
Practice Address - Phone:818-399-9199
Practice Address - Fax:818-343-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-06
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15726261QH0700X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech