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1588978613

NPI Code Detail

MEDICARE: INNOVATIVE REHABILITATION,LLC

MEDICARE: INNOVATIVE REHABILITATION,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
1	235Z00000X	Speech-Language Pathologist	107336	TX
2	225X00000X	Occupational Therapist	111675	TX
3	261QP2000X	Physical Therapy Clinic/Center
4	2355S0801X	Speech-Language Assistant
5	235Z00000X	Speech-Language Pathologist	24933	TX
6	235Z00000X	Speech-Language Pathologist	15485	TX
7	224Z00000X	Occupational Therapy Assistant
8	225200000X	Physical Therapy Assistant
9	225X00000X	Occupational Therapist	109182	TX
10	261QR0400X	Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588978613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE REHABILITATION,LLC

Provider Business Mailing Address
First Line	:	440 HIGHWAY 59 LOOP S STE 104
Second Line	:
City	:	LIVINGSTON
State	:	TX
Zip	:	77351-9011
Country	:	US
Telephone Number	:	936-328-8148
Fax Number	:	936-327-2491

Provider Business Practice Location Address
First Line	:	440 HIGHWAY 59 LOOP S STE 104
Second Line	:
City	:	LIVINGSTON
State	:	TX
Zip	:	77351-9011
Country	:	US
Telephone Number	:	936-328-8148
Fax Number	:	936-327-2491

Authorized Official
Title or Position	:	OWNER/SPEECH LANGUAGE PATHOLOGIST
Name	:	MRS. AMY BETH CROW
Credential	:	SLP
Telephone Number	:	936-328-8148

Provider Enumeration Date	:	07/30/2010
Last Update Date	:	01/24/2025

Similar Medicare Providers

1386582393 — EMILY BURCH COTA
Practice Location Address:

440 HIGHWAY 59 LOOP S STE 104
LIVINGSTON, TX
77351-9011

Practice Phone: 936-328-8148
Practice Fax:

1245668409 — GREGORY CROW MS, SLP INTERN
Practice Location Address:

440 HIGHWAY 59 LOOP S STE 104
LIVINGSTON, TX
77351-9011

Practice Phone: 936-328-8148
Practice Fax: 936-327-2491

1851704886 — SHANA SMITH
Practice Location Address:

440 HIGHWAY 59 LOOP S STE 104
LIVINGSTON, TX
77351-9011

Practice Phone: 936-328-8148
Practice Fax: 936-327-2491

1346788759 — LAUREN CAPELLO
Practice Location Address:

440 HIGHWAY 59 LOOP S STE 104 , SUITE 104
LIVINGSTON, TX
77351-9011

Practice Phone: 936-328-8148
Practice Fax: 936-327-2491

1538683172 — MRS. ASHLEY HOLLIS BA
Practice Location Address:

440 HIGHWAY 59 LOOP S STE 104
LIVINGSTON, TX
77351-9011

Practice Phone: 936-328-8148
Practice Fax:

1548770654 — KAYLEIGH BAYLESS
Practice Location Address:

440 HIGHWAY 59 LOOP S STE 104
LIVINGSTON, TX
77351-9011

Practice Phone: 936-328-8148
Practice Fax: 936-328-8148

Directions to “INNOVATIVE REHABILITATION,LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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