MERCY REHAB SERVICES, INC. , NPI 1801931936 — MERCY KIDS REHAB in SAN JUAN (TX)

NPI 1801931936

13+ Years Experience Organization

MERCY REHAB SERVICES, INC.

Other organization name: MERCY KIDS REHAB. Name type code: 3 - doing business as (d/b/ a) name.

02/20/2007
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1801931936
NPI NUMBER

About MERCY REHAB SERVICES, INC.

MERCY REHAB SERVICES, INC. is a provider established in SAN JUAN, TX. The NPI number of MERCY REHAB SERVICES, INC. is 1801931936 and was assigned on 02/20/2007. The practitioners primary taxonomy code is: 261QR0400X TX .

Mailing address

  • City: SAN JUAN
  • State: TX
  • Postal code: 78589
  • Phone: 9567825800
  • Fax: 9569782582
  • Address: 1205 NORTH RAUL LONGORIA
  • Address 2: SUITE I

Primary Practice Address

  • Region : SAN JUAN, TX
  • NPI : 1801931936
  • Phone : 9567825800
  • Fax : 9567825802
  • Postalcode : 78589
  • Address : 1205 NORTH RAUL LONGORIA SUITE I

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QR0400X
  • License state: TX

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • MERCY REHAB SERVICES, INC.
  • Address : 1205 NORTH RAUL LONGORIA SUITE I
  • Region : SAN JUAN, TX
  • NPI : 1801931936
  • Phone : 9567825800
  • Fax : 9567825802
  • Postalcode : 78589

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 9567825800
  • Title or position : ADMINISTRATOR
  • Credentials : PT

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1205 NORTH RAUL LONGORIA
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE I
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameSAN JUAN
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code78589
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number9567825800
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number9567825802
The fax number associated with the location address of the provider being identified.
NPI1801931936
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QR0400X
Provider Enumeration Date02/20/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MERCY REHAB SERVICES, INC.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameMERCY KIDS REHAB
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address1205 NORTH RAUL LONGORIA
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE I
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameSAN JUAN
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code78589
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number9567825800
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number9569782582
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameREYNA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameJAIME
The first name of the authorized official
Authorized Official Title or PositionADMINISTRATOR
The title or position of the authorized official
Authorized Official Credential TextPT
Authorized Official Credential Text
Authorized Official Telephone Number9567825800
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QR0400X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Provider License Number State Code 1TX
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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