Life Span Rehabilitation Center, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

LIFE SPAN REHABILITATION CENTER, LLC

Practice address

1019 W US Highway 83 Ste P
Alamo, TX 78516-2694

Phone

(956) 601-2274

Fax

(956) 601-2275

NPI assigned

Jan 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Johnny RodriguezNPI 1114522893

Title

President

Phone

(956) 601-2274

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Johnny Rodriguez, COTA

  • Occupational Therapy Assistant
  • Pharr, TX
  • NPI 1114522893
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742083200000",
    "number": "1467503151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1900",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785991900",
            "telephone_number": "956-601-2274",
            "fax_number": "956-601-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 W US HIGHWAY 83 STE P",
            "city": "ALAMO",
            "state": "TX",
            "postal_code": "785162694",
            "telephone_number": "956-601-2274",
            "fax_number": "956-601-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPAN REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2025-03-16",
        "certification_date": "2025-03-16",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-601-2274"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212023001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "0019ME",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIPS",
            "identifier": "137692",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jessica Longoria, COTA
• Tina Gail Longoria
• Anna Elisa Lopez-Zepeda, P.A.

• Rehabilitation Clinic/Center in Alamo, TX
• Providers in Alamo, TX by specialty
• Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.