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General NPI Number Information
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NPI Number | 1952337578
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Entity Type | Organization
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Legal Business Name | ONE SOURCE REHABILITATION, INC.
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3348 E FM 528 RD
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5012
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Country | US
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Telephone | 281-482-1632
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Fax |
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Provider Business Mailing Address
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Address Line | 3348 E FM 528 RD
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5012
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Country | US
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Telephone | 281-482-1632
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CHERYL A CAMINITI
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Credential | PTA
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Telephone | 281-482-1632
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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 | N/A
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License Number State | TX
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