Provider Demographics
NPI:1467602839
Name:SOVEREIGN REHABILITATION OF ARLINGTON, LLC
Entity Type:Organization
Organization Name:SOVEREIGN REHABILITATION OF ARLINGTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:901-213-2340
Mailing Address - Street 1:6050 AIRLINE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9878
Mailing Address - Country:US
Mailing Address - Phone:901-867-8989
Mailing Address - Fax:901-867-8757
Practice Address - Street 1:6050 AIRLINE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-9878
Practice Address - Country:US
Practice Address - Phone:901-867-8989
Practice Address - Fax:901-867-8757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty