Provider Demographics
NPI:1407269418
Name:RISING STARR REHAB SERVICES LLC
Entity Type:Organization
Organization Name:RISING STARR REHAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:GALVAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-847-4055
Mailing Address - Street 1:2885 E GRANT ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-8914
Mailing Address - Country:US
Mailing Address - Phone:956-847-4055
Mailing Address - Fax:956-847-4013
Practice Address - Street 1:2885 E GRANT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-8914
Practice Address - Country:US
Practice Address - Phone:956-847-4055
Practice Address - Fax:956-847-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)