Provider Demographics
NPI:1376110114
Name:SELECT REHABILITATION
Entity Type:Organization
Organization Name:SELECT REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COTA. PRN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:SMITH-REED
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:469-288-1808
Mailing Address - Street 1:209 RUGBY LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-5982
Mailing Address - Country:US
Mailing Address - Phone:469-288-1808
Mailing Address - Fax:
Practice Address - Street 1:3690 MAPLESHADE LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-5715
Practice Address - Country:US
Practice Address - Phone:903-868-0593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation