Provider Demographics
NPI:1417172974
Name:MOBILE REHABILITATION, INC.
Entity Type:Organization
Organization Name:MOBILE REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LABBE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:361-668-0614
Mailing Address - Street 1:2041 E MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4154
Mailing Address - Country:US
Mailing Address - Phone:361-668-0614
Mailing Address - Fax:361-668-0042
Practice Address - Street 1:2041 E MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4154
Practice Address - Country:US
Practice Address - Phone:361-668-0614
Practice Address - Fax:361-668-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100830314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility