Organization
KLUB 4 KIDS REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIANA LOPEZ OTR (MANAGING MEMBER)
(956) 961-4534
Entity
Organization
Contact information
Practice address
805 N CAGE BLVD, SUITE A, PHARR, TX 78577-3109
(956) 961-4534
(956) 961-4210
Mailing address
805 N CAGE BLVD, SUITE A, PHARR, TX 78577-3109
(956) 961-4534
(956) 961-4210
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
09/13/2016
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