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General NPI Number Information
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NPI Number | 1467503151
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Entity Type | Organization
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Legal Business Name | LIFE SPAN REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 03/16/2025
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Provider Practice Location Address
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Address Line | 1019 W US HIGHWAY 83 STE P
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City | ALAMO
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State | TX
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Zip | 78516-2694
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Country | US
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Telephone | 956-601-2274
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Fax | 956-601-2275
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Provider Business Mailing Address
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Address Line | PO BOX 1900
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City | WESLACO
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State | TX
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Zip | 78599-1900
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Country | US
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Telephone | 956-601-2274
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Fax | 956-601-2275
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHNNY RODRIGUEZ
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Credential |
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Telephone | 956-601-2274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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