Healthcare Provider Details

I. General information

NPI: 1295408292
Provider Name (Legal Business Name): HIGH FIVE REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PALO ALTO RD STE 120
SAN ANTONIO TX
78211-3773
US

IV. Provider business mailing address

102 PALO ALTO RD STE 120
SAN ANTONIO TX
78211-3773
US

V. Phone/Fax

Practice location:
  • Phone: 210-922-1785
  • Fax: 210-922-1782
Mailing address:
  • Phone: 210-922-1785
  • Fax: 210-922-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JUAN E. PEREZ
Title or Position: OWNER
Credential:
Phone: 210-922-1785