Provider Demographics
NPI:1477066488
Name:BURLESON REHAB & CARE LLC
Entity Type:Organization
Organization Name:BURLESON REHAB & CARE LLC
Other - Org Name:ALLEGIANT WELLNESS AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAJAL
Authorized Official - Middle Name:GROVER
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-297-4141
Mailing Address - Street 1:724 W RENDON CROWLEY RD
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-5330
Mailing Address - Country:US
Mailing Address - Phone:817-297-4141
Mailing Address - Fax:817-297-4363
Practice Address - Street 1:724 W RENDON CROWLEY RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-5330
Practice Address - Country:US
Practice Address - Phone:817-297-4141
Practice Address - Fax:817-297-4363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility