Provider Demographics
NPI:1922359157
Name:INNOVATIVE IN-HOME PEDIATRIC REHABILITATION INC
Entity Type:Organization
Organization Name:INNOVATIVE IN-HOME PEDIATRIC REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-630-3022
Mailing Address - Street 1:1300 N 10TH ST
Mailing Address - Street 2:STE 480H
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2680
Mailing Address - Country:US
Mailing Address - Phone:956-630-3022
Mailing Address - Fax:956-630-0320
Practice Address - Street 1:1300 N 10TH ST
Practice Address - Street 2:STE 480H
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2680
Practice Address - Country:US
Practice Address - Phone:956-630-3022
Practice Address - Fax:956-630-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health