| Organization Name: | ST. JUDES REHAB SERVICES, INC. |
| NPI Number: | 1285967505 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEONARDO A CHAVEZ (PRESIDENT) |
| Mailing Address: | 6595 Nw 36th St # C218 Virginia Gardens |
| State: | FL US |
| Postal Code: | 331666979 |
| Phone Number: | 3055261408 |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2009 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |