Organization
LIFE SPAN REHABILITATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY RODRIGUEZ (PRESIDENT)
(956) 601-2274
Entity
Organization
Contact information
Practice address
1019 W US HIGHWAY 83 STE P, ALAMO, TX 78516-2694
(956) 601-2274
(956) 601-2275
Mailing address
PO BOX 1900, WESLACO, TX 78599-1900
(956) 601-2274
(956) 601-2275
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019ME
BCBS TX
TX
01
—
137692
CHIPS
TX
05
—
212023001
—
TX
Enumeration date
01/16/2007
Last updated
03/16/2025
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