Provider Demographics
NPI:1760429021
Name:ALVERA REHAB ASSOCIATES, INC
Entity Type:Organization
Organization Name:ALVERA REHAB ASSOCIATES, INC
Other - Org Name:EXPEDIENT HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WALLER
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:972-772-5086
Mailing Address - Street 1:55 NOBLE CT STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6278
Mailing Address - Country:US
Mailing Address - Phone:972-772-2565
Mailing Address - Fax:
Practice Address - Street 1:2455 RIDGE RD STE 205
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087
Practice Address - Country:US
Practice Address - Phone:972-772-5086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008625251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX008625OtherHOME HEALTH LICENSE
TX679377Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER