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General NPI Number Information
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NPI Number | 1326421173
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Entity Type | Organization
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Legal Business Name | COSTA THERAPY INSTITUTE, LLC
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 2740 W ALTON GLOOR BLVD STE A
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City | BROWNSVILLE
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State | TX
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Zip | 78520-4476
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Country | US
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Telephone | 956-982-8578
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Fax | 956-982-8741
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Provider Business Mailing Address
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Address Line | 7308 DOMINICA DR
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City | BROWNSVILLE
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State | TX
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Zip | 78520-4036
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Country | US
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Telephone |
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Fax | 956-982-8741
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CYNTHIA SELVERA
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Credential |
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Telephone | 956-465-7756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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