Provider Demographics
NPI:1053850362
Name:CENTRA REHAB & THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:CENTRA REHAB & THERAPEUTIC SERVICES
Other - Org Name:NISSI REHAB & THERAPEUTIC SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINTUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-701-7993
Mailing Address - Street 1:8700 COMMERCE PARK DR
Mailing Address - Street 2:155
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7497
Mailing Address - Country:US
Mailing Address - Phone:713-701-7993
Mailing Address - Fax:832-553-7626
Practice Address - Street 1:8700 COMMERCE PARK DR
Practice Address - Street 2:155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7497
Practice Address - Country:US
Practice Address - Phone:713-701-7993
Practice Address - Fax:832-553-7626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225XG0600X225XG0600X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontologyGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty