NPIMap

Organization Active NPI

Little Lighthouse Childrens Rehab

  • Rehabilitation Clinic/Center
  • Los Fresnos, TX
National Provider Identifier
1942398151
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
LITTLE LIGHTHOUSE CHILDRENS REHAB
Practice address
503 W Ocean Blvd Ste B
Los Fresnos, TX 78566-3620
Phone
(956) 233-4111
Fax
(956) 233-4115
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Mr. Rick Lee Perez
Title
Assitant Administrator
Phone
(956) 943-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

503 W Ocean Blvd Ste B
Los Fresnos, TX 78566-3620

Mailing address

503 W Ocean Blvd Ste B
Los Fresnos, TX 78566-3620
Phone (956) 233-4111

Other identifiers 1

IdentifierTypeStateIssuer
174327001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000328 TX Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0941255418 2 other NPIs on this enrollment
Practice locations: Port Isabel, TX; Los Fresnos, TX; La Feria, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Little Lighthouse Children'S Rehab 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.

Locations

400 E Main St
Alice, TX 78332
Phone (361) 369-4029

Practitioners & affiliated clinicians

Practitioners 66

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

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1942398151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 W OCEAN BLVD STE B",
            "city": "LOS FRESNOS",
            "state": "TX",
            "postal_code": "785663620",
            "telephone_number": "956-233-4111",
            "fax_number": "956-233-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 W OCEAN BLVD STE B",
            "city": "LOS FRESNOS",
            "state": "TX",
            "postal_code": "785663620",
            "telephone_number": "956-233-4111",
            "fax_number": "956-233-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE LIGHTHOUSE CHILDRENS REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ASSITANT ADMINISTRATOR",
        "authorized_official_telephone_number": "956-943-9600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174327001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Fresnos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.