Provider Demographics
NPI:1871658914
Name:COMMUNITY REHAB OF CORPUS CHRISTI, INC.
Entity Type:Organization
Organization Name:COMMUNITY REHAB OF CORPUS CHRISTI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:NORINE
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-814-7100
Mailing Address - Street 1:601 TEXAN TRL STE 101
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2548
Mailing Address - Country:US
Mailing Address - Phone:361-814-7100
Mailing Address - Fax:361-814-7101
Practice Address - Street 1:601 TEXAN TRL STE 101
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2548
Practice Address - Country:US
Practice Address - Phone:361-814-7100
Practice Address - Fax:361-814-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008695251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679463Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER