Healthcare Provider Details

I. General information

NPI: 1942492558
Provider Name (Legal Business Name): AUSTIN REHAB OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E LIVE OAK ST
AUSTIN TX
78704-4355
US

IV. Provider business mailing address

306 W 7TH ST STE 415
FORT WORTH TX
76102-4905
US

V. Phone/Fax

Practice location:
  • Phone: 512-444-3511
  • Fax: 512-444-6428
Mailing address:
  • Phone: 817-335-4111
  • Fax: 817-335-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number119262
License Number StateTX

VIII. Authorized Official

Name: CHARLES KENT HARRINGTON
Title or Position: PRESIDENT
Credential:
Phone: 817-335-4111