State Community Rehab Agency, Inc.

Primary specialty

Rehabilitation Hospital UnitTaxonomy code 273Y00000X

Legal business name

STATE COMMUNITY REHAB AGENCY, INC.

Practice address

11205 Main St Ste 118
Houston, TX 77025-5602

Phone

(713) 662-0501

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carolyn Mickens

Title

Coordinator

Phone

(713) 662-0502

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922107325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 MAIN ST STE 118",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255602",
            "telephone_number": "713-662-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11205 MAIN ST STE 118",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255602",
            "telephone_number": "713-662-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE COMMUNITY REHAB AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MICKENS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "713-662-0502",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Hospital Unit in Houston, TX
• Providers in Houston, TX by specialty
• Rehabilitation Hospital Unit in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.