Organization
REBORN THERAPY CENTER
Active
Other names
Chateau Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HECTOR L RODRIGUEZ JR. AB (DIRECTOR)
(321) 337-9391
Entity
Organization
Contact information
Practice address
4710 W IRLO BRONSON MEMORIAL HWY, KISSIMMEE, FL 34746-5325
(321) 337-9391
(407) 264-6421
Mailing address
4710 W IRLO BRONSON MEMORIAL HWY, KISSIMMEE, FL 34746-5325
(407) 738-0586
(321) 250-7463
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
09/08/2021
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