Healthcare Provider Details

I. General information

NPI: 1134172646
Provider Name (Legal Business Name): ACTIONCARE REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10450 BRIAN MOONEY AVE
EL PASO TX
79935-2809
US

IV. Provider business mailing address

10450 BRIAN MOONEY AVE
EL PASO TX
79935-2809
US

V. Phone/Fax

Practice location:
  • Phone: 915-598-6618
  • Fax: 915-598-6651
Mailing address:
  • Phone: 915-598-6618
  • Fax: 915-598-6651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ISRAEL MALDONADO
Title or Position: IN- DIRECT OWNER
Credential:
Phone: 915-598-6618