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NPI Code Detail

MEDICARE: LOS NINOS REHABILITATION CENTER, LLC

MEDICARE: LOS NINOS REHABILITATION CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1124231790
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOS NINOS REHABILITATION CENTER, LLC
Provider Business Mailing Address
First Line : 4437 LAZY WILLOW DR
Second Line :
City : EL PASO
State : TX
Zip : 79922-1857
Country : US
Telephone Number : 915-544-6466
Fax Number : 915-532-2348
Provider Business Practice Location Address
First Line : 3333 N MESA ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-2031
Country : US
Telephone Number : 915-544-6466
Fax Number : 915-532-2348
Authorized Official
Title or Position : ADMINISTRATOR
Name : DR. SCOTTI S BALLMER-PITTMAN
Credential : D.C.
Telephone Number : 915-544-6466
Provider Enumeration Date : 05/08/2007
Last Update Date : 08/22/2020

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Directions to “LOS NINOS REHABILITATION CENTER, LLC ” Practice Location

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