NPIMap

Organization Active NPI

Reimagine Network

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Fullerton, CA
National Provider Identifier
1306441076
Registry record updated Apr 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
REIMAGINE NETWORK
Practice address
130 Laguna Rd Ste a
Fullerton, CA 92835-3650
Phone
(714) 680-6060
NPI assigned
Dec 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Christian Eric Erlenbush, LCSW
Title
Senior Director - Clinical Services
Phone
(714) 633-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

130 Laguna Rd Ste a
Fullerton, CA 92835-3650

Mailing address

130 Laguna Rd Ste a
Fullerton, CA 92835-3650
Phone (714) 680-6060

National Provider Directory

National Provider Directory
Tax ID family
Reimagine Network4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

130 Laguna Rd
Ste A
Fullerton, CA 92835
Phone (714) 680-6060

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617408000000",
    "number": "1306441076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LAGUNA RD STE A",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353650",
            "telephone_number": "714-680-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LAGUNA RD STE A",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353650",
            "telephone_number": "714-680-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REIMAGINE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2021-04-03",
        "certification_date": "2021-04-03",
        "status": "A",
        "authorized_official_last_name": "ERLENBUSH",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "SENIOR DIRECTOR - CLINICAL SERVICES",
        "authorized_official_telephone_number": "714-633-7400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.