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NPI Code Detail

MEDICARE: LAGUNA MADRE REHABILITATION CENTER

MEDICARE: LAGUNA MADRE REHABILITATION CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841399623
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAGUNA MADRE REHABILITATION CENTER
Provider Business Mailing Address
First Line : 225 MESQUITE DRIVE
Second Line :
City : LAGUNA VISTA
State : TX
Zip : 78578-2450
Country : US
Telephone Number : 956-943-2248
Fax Number : 956-943-4459
Provider Business Practice Location Address
First Line : 1200 STATE HIGHWAY 100
Second Line : STE 9
City : PORT ISABEL
State : TX
Zip : 78578-2708
Country : US
Telephone Number : 956-943-2248
Fax Number : 956-943-4459
Authorized Official
Title or Position : ADMINISTRATOR/OWNER
Name : MR. ANDY LEE PLATTNER
Credential :
Telephone Number : 956-943-2248
Provider Enumeration Date : 09/21/2006
Last Update Date : 08/21/2012

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Directions to “LAGUNA MADRE REHABILITATION CENTER ” Practice Location

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