Healthcare Provider Details

I. General information

NPI: 1801461298
Provider Name (Legal Business Name): REHAB DIRECTIVES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 MALL RING CIR
HENDERSON NV
89014-6619
US

IV. Provider business mailing address

3165 N RAINBOW BLVD
LAS VEGAS NV
89108-4578
US

V. Phone/Fax

Practice location:
  • Phone: 702-767-3177
  • Fax: 702-803-9677
Mailing address:
  • Phone: 702-463-6555
  • Fax: 702-803-9677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID WATSON GILBERT
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-570-6222