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Organization
TS CARLSON PEDIATRIC REHAB LP
Active
Organization
TS CARLSON PEDIATRIC REHAB LP
Active
Other names
HealthStar Pediatric Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACI LYN CARLSON SLP (OWNER/ADMINISTRATOR)
(915) 779-7827
Entity
Organization
Contact information
Practice address
6800 GATEWAY BLVD E, BLDG 4A, EL PASO, TX 79915-1040
(915) 779-7827
(915) 779-7829
Mailing address
6800 GATEWAY BLVD E, BLDG 4A, EL PASO, TX 79915-1040
(915) 779-7827
(915) 779-7829
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295233501
—
TX
Enumeration date
12/13/2011
Last updated
08/19/2015
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