NPIMap

Organization Active NPI

Rehability Therapy Center LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • San Juan, TX
National Provider Identifier
1992945406
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
REHABILITY THERAPY CENTER LLC
Practice address
1110 S Stewart Rd Ste D
San Juan, TX 78589
Phone
(956) 283-7555
Fax
(956) 283-7557
NPI assigned
Feb 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Roxanne RuizNPI 1245352673
Title
President
Phone
(956) 283-7555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

1110 S Stewart Rd Ste D
San Juan, TX 78589

Mailing address

1110 S Stewart Rd Ste D
San Juan, TX 78589-5168
Phone (956) 283-7555

Other identifiers 3

IdentifierTypeStateIssuer
210777301MedicaidTX
676573OtherTXMEDICARE TRAILBLAZER
676573OtherTXMEDICARE- NOVITAS SOLUTIONS, INC.

Other names 1

  • LIFE SKILLS THERAPY CENTER OF SAN JUAN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090708000620 TX Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 8628120433 Practice locations: San Juan, TX

Outpatient physical therapy / speech pathology certification: CCN 676573

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LIFE SKILLS THERAPY CENTER OF SAN JUAN
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
May 5, 2004
Last certification
Jan 19, 2016
Ownership / control type
Proprietary
Most recent change of ownership
Jun 4, 2009
Facility address
1110 South Stewart Rd, Suite D
San Juan, TX 78589

National Provider Directory

National Provider Directory

Locations

1110 S Stewart Rd
Ste D
San Juan, TX 78589
Phone (956) 283-7555

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1992945406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 S STEWART RD STE D",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785895168",
            "telephone_number": "956-283-7555",
            "fax_number": "956-283-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S STEWART RD STE D",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "78589",
            "telephone_number": "956-283-7555",
            "fax_number": "956-283-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITY THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-283-7555"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210777301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAILBLAZER",
            "identifier": "676573",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- NOVITAS SOLUTIONS, INC.",
            "identifier": "676573",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFE SKILLS THERAPY CENTER OF SAN JUAN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LIFE SKILLS THERAPY CENTER OF SAN JUAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan, TX

Sources for this page

Verify at the official NPI Registry.