Provider Demographics
NPI:1861078164
Name:HIGHRISE PREMIER REHABILITATION SERVICES LLC
Entity type:Organization
Organization Name:HIGHRISE PREMIER REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:UZOOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:UTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-877-5303
Mailing Address - Street 1:1200 S FIGUEROA ST APT 1023
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-4476
Mailing Address - Country:US
Mailing Address - Phone:810-877-5303
Mailing Address - Fax:
Practice Address - Street 1:1200 S FIGUEROA ST APT 1023
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-4476
Practice Address - Country:US
Practice Address - Phone:323-607-7135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)