Healthcare Provider Details

I. General information

NPI: 1417420977
Provider Name (Legal Business Name): REHAB DIRECTIVES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 W NEVSO DR
LAS VEGAS NV
89147-0407
US

IV. Provider business mailing address

3213 W CHARLESTON BLVD STE 105
LAS VEGAS NV
89102-1991
US

V. Phone/Fax

Practice location:
  • Phone: 702-570-6222
  • Fax: 702-702-9428
Mailing address:
  • Phone: 702-570-6222
  • Fax: 702-570-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

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