Provider Demographics
NPI:1528672391
Name:PRO REHAB ONE LLC
Entity type:Organization
Organization Name:PRO REHAB ONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISMENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-802-1598
Mailing Address - Street 1:1929 W US HIGHWAY 83
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6313
Mailing Address - Country:US
Mailing Address - Phone:956-802-1598
Mailing Address - Fax:
Practice Address - Street 1:1929 W US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6313
Practice Address - Country:US
Practice Address - Phone:956-802-1598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation