Provider Demographics
NPI:1710378948
Name:NISSI REHAB AND THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:NISSI REHAB AND THERAPEUTIC SERVICES
Other - Org Name:NISSI THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FOLASADE
Authorized Official - Middle Name:A
Authorized Official - Last Name:AKINTUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-490-9300
Mailing Address - Street 1:7430 BOXWOOD RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3851
Mailing Address - Country:US
Mailing Address - Phone:832-490-9300
Mailing Address - Fax:
Practice Address - Street 1:7430 BOXWOOD RIDGE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3851
Practice Address - Country:US
Practice Address - Phone:832-490-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty