Organization
GOOD SHEPHERD REHAB INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL ABEJUELA (CEO)
(702) 893-3333
Entity
Organization
Contact information
Practice address
4275 BURNHAM AVE STE 255, LAS VEGAS, NV 89119-8204
(702) 380-1060
(702) 380-1081
Mailing address
4275 BURNHAM AVE STE 255, LAS VEGAS, NV 89119-8204
(702) 380-1060
(702) 380-1081
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
20071354581
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001702161
—
NV
Enumeration date
03/30/2011
Last updated
03/30/2011
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