Provider Demographics
NPI:1295408292
Name:HIGH FIVE REHAB LLC
Entity Type:Organization
Organization Name:HIGH FIVE REHAB LLC
Other - Org Name:HIGH FIVE KIDS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-922-1785
Mailing Address - Street 1:102 PALO ALTO RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-3773
Mailing Address - Country:US
Mailing Address - Phone:210-922-1785
Mailing Address - Fax:210-922-1782
Practice Address - Street 1:102 PALO ALTO RD STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3773
Practice Address - Country:US
Practice Address - Phone:210-922-1785
Practice Address - Fax:210-922-1782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX430962701Medicaid