Klub 4 Kids Rehab, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

KLUB 4 KIDS REHAB, LLC

Practice address

805 N Cage Blvd
Suite a
Pharr, TX 78577-3109

Phone

(956) 961-4534

Fax

(956) 961-4210

NPI assigned

Oct 22, 2014

Organization subpart

No

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

Authorized official

Name

Liliana Lopez, OTR

Title

Managing Member

Phone

(956) 961-4534

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 676727

Legal name

KLUB 4 KIDS REHAB, LLC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Apr 20, 2016

Last certification

Apr 20, 2016

Ownership / control type

Proprietary

Facility address

805 N Cage Blvd Suite a
Pharr, TX 78577

Locations

Practitioners 1

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

• Lauren N Garcia, SLP

  • Speech-Language Pathologist
  • Pharr, TX
  • NPI 1184082034
  NPD (past)

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1548664394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N CAGE BLVD",
            "address_2": "SUITE A",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785773109",
            "telephone_number": "956-961-4534",
            "fax_number": "956-961-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N CAGE BLVD",
            "address_2": "SUITE A",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785773109",
            "telephone_number": "956-961-4534",
            "fax_number": "956-961-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLUB 4 KIDS REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LILIANA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "956-961-4534",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Clinic/Center in Pharr, TX
• Providers in Pharr, 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 Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.