Organization Name: | LITTLE LIGHTHOUSE CHILDRENS REHAB |
NPI Number: | 1942398151 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICK LEE PEREZ (ASSITANT ADMINISTRATOR) |
Mailing Address: | 503 W Ocean Blvd Ste B Los Fresnos |
State: | TX US |
Postal Code: | 785663620 |
Phone Number: | 9562334111 |
Fax Number: | 9562334115 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 04/25/2012 |
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: |