Provider Demographics
NPI:1154004984
Name:INTEGRATED REHABILITATION CENTER
Entity type:Organization
Organization Name:INTEGRATED REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/BCBA
Authorized Official - Phone:305-826-7884
Mailing Address - Street 1:5931 NW 173RD DR UNIT 10
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5107
Mailing Address - Country:US
Mailing Address - Phone:305-826-7884
Mailing Address - Fax:
Practice Address - Street 1:5931 NW 173RD DR UNIT 10
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5107
Practice Address - Country:US
Practice Address - Phone:305-826-7884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency