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Organization
FUN HOUSE REHAB, LLC
Active
Organization
FUN HOUSE REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOE BAZAN OTR (OWNER)
(956) 638-0761
Entity
Organization
Contact information
Practice address
11837 ACOSTA CIR W, MISSION, TX 78573-7995
(956) 638-0761
Mailing address
9620 STATE HIGHWAY 107, MISSION, TX 78573-8495
(956) 638-0761
(956) 329-2830
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/29/2019
Last updated
04/08/2019
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