MEDICARE: REHABILITIES PARTNERS 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	261QR0400X	Rehabilitation Clinic/Center	111169	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0A4658	OTHER	TX	MEDICARE PTAN

General Provider Information

NPI Number	:	1609002302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITIES PARTNERS LLC

Provider Business Mailing Address
First Line	:	7230 GATEWAY BLVD E STE F
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-1353
Country	:	US
Telephone Number	:	915-595-4500
Fax Number	:	915-595-4502

Provider Business Practice Location Address
First Line	:	7230 GATEWAY BLVD E
Second Line	:	SUITE F
City	:	EL PASO
State	:	TX
Zip	:	79915-1352
Country	:	US
Telephone Number	:	915-595-4500
Fax Number	:	915-595-4502

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PATRICIA E. ELLISON
Credential	:	OTR
Telephone Number	:	915-595-4500

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	08/04/2014

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Directions to “REHABILITIES PARTNERS LLC ” Practice Location

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