Provider Demographics
NPI:1467566919
Name:REHAB4KIDS, LLC
Entity Type:Organization
Organization Name:REHAB4KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-519-9700
Mailing Address - Street 1:8700 9TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8076
Mailing Address - Country:US
Mailing Address - Phone:409-722-5437
Mailing Address - Fax:409-722-5435
Practice Address - Street 1:8700 9TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8076
Practice Address - Country:US
Practice Address - Phone:409-722-5437
Practice Address - Fax:409-722-5435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184691701Medicaid