Trailhead Health and Rehab LLC
Clinic/Center (Physical Therapy)

Address: 1838 W Parkside Ln Ste 110, Phoenix, AZ 85027-1370
Phone: 9707122938

Trailhead Health and Rehab LLC (NPI# 1568079523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1568079523
Entity Type Organization
Practice Address 1838 W Parkside Ln Ste 110
AZ 85027-1370
Practice Telephone 9707122938
Mailing Address Po Box 5718
MT 59903-5718
Mailing Telephone 4067560134
Mailing Fax Number 4063001612
Authorized Official Name Blaine Stimac (MANAGING MEMBER)
Authorized Official Telephone 4067561128
Authorized Official Credential MSPT
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2020-09-24
Last Update Date 2020-09-24

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 225200000X Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Yes 261QP2000X Clinic/Center · Physical Therapy Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Trailhead Physical Therapy & Sports Medicine Doing Business As Name - Organization

Taxonomy Information

Taxonomy Code 261QP2000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Physical Therapy

Taxonomy Definition

Definition to come...

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Office Location

Street Address 1838 W PARKSIDE LN STE 110
State AZ
Zip Code 85027-1370

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Zip Code 85027

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.