# STATE COMMUNITY REHAB AGENCY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922107325
- **Authorized official:** MRS. CAROLYN MICKENS (COORDINATOR)
- **Authorized official phone:** (713) 662-0502

## Contact information

- **Practice address:** 11205 MAIN ST STE 118, HOUSTON, TX 77025-5602
- **Practice address phone:** (713) 662-0501
- **Mailing address:** 11205 MAIN ST STE 118, HOUSTON, TX 77025-5602
- **Mailing address phone:** (713) 662-0501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 273Y00000X | Rehabilitation Hospital Unit | — | NULL | Yes |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 08/22/2020