BACK TO LIFE LLC (NPI# 1063063014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063063014 |
| Entity Type | Organization |
| Organization Name | BACK TO LIFE LLC |
| Practice Address |
305 E 1st St Malvern IA 51551-8008 |
| Mailing Address |
Po Box 178 Malvern IA 51551-0178 |
| Practice Telephone | 4022017852 |
| Mailing Telephone | 4022017852 |
| Enumeration Date | 2019-09-21 |
| Last Update Date | 2019-09-21 |
| Authorized Official Name | AMBERLY WIESE (OWNER) |
| Authorized Official Telephone | 4022017852 |
| Authorized Official Credential | OT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356621700 | Back To Life LLC | Chiropractor | 2323 Ne 26th Ave, Pompano Beach, FL 33062-1147 | 2011-08-17 |
| 1093038010 | Back To Life LLC | Chiropractor | 3 Elmwood Rd, Hancock, NH 03449-5629 | 2010-03-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | BACK TO LIFE LLC | 360 Naugatuck Ave., Milford, CT 06461 |
| Colorado Business Entities | Back to Life LLC | 7203 Arkansas St, Frederick, CO 80530 |
| Street Address |
305 E 1ST ST |
| City | MALVERN |
| State | IA |
| Zip Code | 51551-8008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942513379 | Amberly Wiese | Occupational Therapist | 305 E 1st St, Malvern, IA 51551-8008 | 2010-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790832038 | Malvern C.s.d. | Local Education Agency (LEA) | 1505 E. 15th St., Malvern, IA 51551 | 2007-01-05 |
| 1386730109 | Physicians Clinic, Inc. | Durable Medical Equipment & Medical Supplies | 107 East 4th Street, Malvern, IA 51551 | 2006-10-05 |
| 1104989714 | Collins Drug | Pharmacy | 407 Main St, Malvern, IA 51551 | 2006-12-18 |
| 1285723163 | Malvern Volunteer Rescue, Inc. | Ambulance | 110 W 5th Street, Malvern, IA 51551-0058 | 2006-10-11 |
| 1619932662 | Manor of Malvern Inc. | Skilled Nursing Facility | 903 2nd Ave, Malvern, IA 51551-4059 | 2006-04-20 |
| 1588991301 | Morse Healthcare Services Inc. | Skilled Nursing Facility | 903 2nd Ave, Malvern, IA 51551-4059 | 2009-11-16 |
| 1033594551 | Kaleb Richter | Physical Therapy Assistant | 204 E 8th St, Malvern, IA 51551-4062 | 2015-07-26 |
| 1336252097 | Thomas M Baer | Family Medicine | 307 Main St, Malvern, IA 51551-8032 | 2006-08-16 |
| 1184021123 | Lancial Chiropractic | Chiropractor | 414 Main St, Malvern, IA 51551-8033 | 2014-11-19 |
| 1457756116 | Natalie Lancial | Chiropractor | 414 Main St, Malvern, IA 51551-8033 | 2014-10-23 |
| Find all providers in zip 51551 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588218044 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 30 Liberty Boulevard, Suite 140, Malvern, PA 19355 | 2019-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285233064 | Physiotherapy Associates, Inc. | Clinic/Center | 998 Westdale Parkway, Cedar Rapids, IA 52404 | 2020-10-22 |
| 1053924449 | Pella Regional Health Center | Clinic/Center | 404 S Commerce, Prairie City, IA 50228-8560 | 2020-08-26 |
| 1730702275 | Physiotherapy Associates, Inc. | Clinic/Center | 87 Paine St Se Ste 1&2, Bondurant, IA 50035-1451 | 2020-05-19 |
| 1821617069 | Physiotherapy Assoicates, Inc. | Clinic/Center | 319 7th St Ste 102, Des Moines, IA 50309-3812 | 2020-04-08 |
| 1194354795 | Physiotherapy Assoicates, Inc. | Clinic/Center | 87 Paine St Se, Bondurant, IA 50035-1451 | 2020-04-06 |
| 1245892629 | On With Life, Inc | Clinic/Center | 2854 Coral Court, Suite 1, Coralville, IA 52241 | 2019-07-05 |
| 1982265559 | Physiotherapy Associates, Inc. | Clinic/Center | 516 Nile Kinnick Dr S Ste B, Adel, IA 50003-2076 | 2019-06-25 |
| 1548820145 | Physiotherapy Associates, Inc. | Clinic/Center | 1327 Sunset Dr # 400, Norwalk, IA 50211-1343 | 2019-06-17 |
| 1952822801 | Physiotherapy Assoicates, Inc. | Clinic/Center | 9500 University Ave Ste 1115, West Des Moines, IA 50266-1745 | 2017-06-30 |
| 1659746766 | Physiotherapy Associates Inc | Clinic/Center | 3111 Gordon Dr, Sioux City, IA 51105-3730 | 2015-12-01 |
| Find all providers with the same taxonomy | ||||
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| 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.