Provider Demographics
NPI:1083071625
Name:GO GO CARE REHAB LLC
Entity Type:Organization
Organization Name:GO GO CARE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BALDEMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-502-5717
Mailing Address - Street 1:912 E NOLANA LOOP
Mailing Address - Street 2:SUITE G
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5838
Mailing Address - Country:US
Mailing Address - Phone:956-502-5717
Mailing Address - Fax:956-720-0882
Practice Address - Street 1:912 E NOLANA LOOP
Practice Address - Street 2:SUITE G
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5838
Practice Address - Country:US
Practice Address - Phone:956-502-5717
Practice Address - Fax:956-720-0882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation