Healthcare Provider Details
I. General information
NPI: 1689073637
Provider Name (Legal Business Name): SENIOR REHAB SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2014
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2828 N HARWOOD ST STE 2000
DALLAS TX
75201-2124
US
IV. Provider business mailing address
2828 N HARWOOD ST STE 2000
DALLAS TX
75201-2124
US
V. Phone/Fax
- Phone: 214-252-7600
- Fax: 214-252-7599
- Phone: 214-252-7600
- Fax: 214-252-7599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 227800000X |
| Taxonomy | Certified Respiratory Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
BRANDLEY
Title or Position: PRESIDENT
Credential:
Phone: 214-252-7600