Provider Demographics
NPI:1346537990
Name:ELITE REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:ELITE REHAB SERVICES, LLC
Other - Org Name:ELITE REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTEO
Authorized Official - Middle Name:C
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-380-6100
Mailing Address - Street 1:2115 PLEASANTON RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1300
Mailing Address - Country:US
Mailing Address - Phone:956-380-6100
Mailing Address - Fax:
Practice Address - Street 1:2115 PLEASANTON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1300
Practice Address - Country:US
Practice Address - Phone:956-380-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation