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General NPI Number Information
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NPI Number | 1477809879
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Entity Type | Organization
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Legal Business Name | SAFARI PEDIATRIC REHAB,LLC.
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Dates
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Enumeration Date | 08/03/2012
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 3406 W ALBERTA RD
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City | EDINBURG
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State | TX
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Zip | 78539-8465
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Country | US
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Telephone | 956-686-9453
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Fax | 956-287-3715
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Provider Business Mailing Address
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Address Line | 3406 W ALBERTA RD
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City | EDINBURG
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State | TX
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Zip | 78539-8465
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Country | US
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Telephone | 956-686-9453
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Fax | 956-287-3715
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SONOIA A. PEREZ
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Credential |
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Telephone | 956-686-9453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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