Provider Demographics
NPI:1811901739
Name:WHISTLE STOP CHILDREN'S REHABILITATION CENTER L L P
Entity type:Organization
Organization Name:WHISTLE STOP CHILDREN'S REHABILITATION CENTER L L P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-233-5400
Mailing Address - Street 1:224 W OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-3623
Mailing Address - Country:US
Mailing Address - Phone:956-233-5400
Mailing Address - Fax:956-233-5406
Practice Address - Street 1:224 W OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566-3623
Practice Address - Country:US
Practice Address - Phone:956-233-5400
Practice Address - Fax:956-233-5406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX554670000261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)