Reborn Therapy Center

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

REBORN THERAPY CENTER

Practice address

4710 W Irlo Bronson Memorial Hwy
Kissimmee, FL 34746-5325

Phone

(321) 337-9391

Fax

(407) 264-6421

NPI assigned

Feb 3, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Hector L Rodriguez Jr., AB

Title

Director

Phone

(321) 337-9391

Specialties & licenses 2

Addresses

Other names 1

• Chateau Group Home Doing business as

Tax ID family

2450 Chateau LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• 2450 Chateau LLC

  • Developmental Disabilities Clinic/Center
  • Kissimmee, FL
  • NPI 1548890700
  NPD tax ID

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1730710211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 W IRLO BRONSON MEMORIAL HWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465325",
            "telephone_number": "407-738-0586",
            "fax_number": "321-250-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 W IRLO BRONSON MEMORIAL HWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465325",
            "telephone_number": "321-337-9391",
            "fax_number": "407-264-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBORN THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "321-337-9391",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "AB"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chateau Group Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chateau Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Real Health America, LLC
• Realizing Excellence and Challenging Hearts, LLC
• Caelan Reamer, OTR/L
• Rebeca Feliciano
• Reborn Therapy Center
• Reclaiming Potential
• Red Mountain Emergency Physicians LLC
• Amogh Damidi Reddy
• Sriya Aerra Reddy
• Sumeet Kumar Reddy, MD

• Adolescent and Children Mental Health Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.