# REHAB CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Wellness Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245456540
- **Authorized official:** RANDAL FLOYD OTAIDE (LC MANAGER)
- **Authorized official phone:** (469) 212-3261

## Contact information

- **Practice address:** 5519 ARAPAHO ROAD, SUITE 108, DALLAS, TX 75248
- **Practice address phone:** (469) 212-3261
- **Practice address fax:** (214) 484-5990
- **Mailing address:** 18208 PRESTON RD, SUITE D9320, DALLAS, TX 75252-6007
- **Mailing address phone:** (469) 212-3261
- **Mailing address fax:** (214) 484-5990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | 25360 | TX | — |
| 111NN0400X | Neurology Chiropractor | 5539 | TX | Yes |
| 225X00000X | Occupational Therapist | 104540 | TX | — |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 09/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0020JN | BCBS | TX |