OrganizationActive
Innovative Rehabilitation LLC
NPI 1114260494 · Comprehensive Outpatient Rehabilitation Facility (CORF) · Glendale, AZ
Provider details
- NPI number
- 1114260494
- Entity type
- Organization
- Primary specialty
- Comprehensive Outpatient Rehabilitation Facility (CORF)Ambulatory Health Care Facilities
- Authorized official
- Charles Guzman, President
- License
- OTC5691 (AZ)
Practice location
5146 W Whispering Wind Dr
Glendale, AZ 85310-2910
Phone: (623) 738-0479
Fax: (623) 738-0479
Mailing address
5146 W Whispering Wind Dr
Glendale, AZ 85310-2910
Registry dates
- Enumerated
- 2013-04-04
- Last updated
- 2013-07-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.