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General NPI Number Information
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NPI Number | 1417172974
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Entity Type | Organization
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Legal Business Name | MOBILE REHABILITATION, INC.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 2041 E MAIN ST STE 100
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City | ALICE
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State | TX
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Zip | 78332-4154
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Country | US
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Telephone | 361-668-0614
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Fax | 361-668-0042
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Provider Business Mailing Address
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Address Line | 2041 E MAIN ST STE 100
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City | ALICE
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State | TX
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Zip | 78332-4154
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Country | US
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Telephone | 361-668-0614
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Fax | 361-668-0042
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Authorized Official
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Title or Position | OWNER
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Name | MS. EDNA T. LABBE
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Credential | OTR
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Telephone | 361-668-0614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 100830
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License Number State | TX
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