MEDICARE: LEAPS & BOUNDS PEDIATRIC REHABILITATION CENTER, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	224Z00000X	Occupational Therapy Assistant
2	2251P0200X	Pediatric Physical Therapist
3	225200000X	Physical Therapy Assistant
4	225XP0200X	Pediatric Occupational Therapist
5	2355S0801X	Speech-Language Assistant
6	235Z00000X	Speech-Language Pathologist
7	225100000X	Physical Therapist
8	225X00000X	Occupational Therapist
9	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	TX
10	251E00000X	Home Health Agency
11	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34LV	OTHER	TX	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245331396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEAPS & BOUNDS PEDIATRIC REHABILITATION CENTER, INC.

Provider Business Mailing Address
First Line	:	1005 E NOLANA AVE
Second Line	:	STE. C
City	:	MCALLEN
State	:	TX
Zip	:	78504-6101
Country	:	US
Telephone Number	:	956-630-6300
Fax Number	:	956-686-2942

Provider Business Practice Location Address
First Line	:	1005 E NOLANA AVE
Second Line	:	STE. C
City	:	MCALLEN
State	:	TX
Zip	:	78504-6101
Country	:	US
Telephone Number	:	956-630-6300
Fax Number	:	956-686-2942

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ANGELA PECHERO
Credential	:	R.N.
Telephone Number	:	956-630-6300

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/29/2013

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