Provider Demographics
NPI:1477809879
Name:SAFARI PEDIATRIC REHAB,LLC.
Entity Type:Organization
Organization Name:SAFARI PEDIATRIC REHAB,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONOIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-686-9453
Mailing Address - Street 1:3406 W ALBERTA RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8465
Mailing Address - Country:US
Mailing Address - Phone:956-686-9453
Mailing Address - Fax:956-287-3715
Practice Address - Street 1:3406 W ALBERTA RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8465
Practice Address - Country:US
Practice Address - Phone:956-686-9453
Practice Address - Fax:956-287-3715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty