Organization
RENAISSANCE OUTPATIENT REHABILITATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IMEDA CASTILLO MS,CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(956) 586-2600
Entity
Organization
Contact information
Practice address
2010 E GRIFFIN PKWY, MISSION, TX 78572-3223
(956) 583-2600
(956) 583-8580
Mailing address
2010 E GRIFFIN PKWY, MISSION, TX 78572-3223
(956) 583-2600
(956) 583-8580
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
103816
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103816
STATE LICENSE
TX
Enumeration date
07/31/2008
Last updated
07/31/2008
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