Provider Demographics
NPI:1316363005
Name:REHAB TRIFECTA, LLC
Entity Type:Organization
Organization Name:REHAB TRIFECTA, LLC
Other - Org Name:ALAMO REHAB SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHERA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEEVANJEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:888-568-7262
Mailing Address - Street 1:213 SADIE STREET
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210
Mailing Address - Country:US
Mailing Address - Phone:888-568-7262
Mailing Address - Fax:210-568-4419
Practice Address - Street 1:213 SADIE STREET
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210
Practice Address - Country:US
Practice Address - Phone:888-568-7262
Practice Address - Fax:210-568-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016350251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health