Organization
LITTLE STAR REHAB
Active
Other names
Little Stars Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA WATSON (OWNER)
(817) 822-9195
Entity
Organization
Contact information
Practice address
4525 ALTAMESA BLVD, FORT WORTH, TX 76133
(817) 822-9195
Mailing address
4525 ALTAMESA BLVD, FORT WORTH, TX 76133
(817) 822-9195
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
05/07/2012
Last updated
11/19/2012
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