Organization
BONAFIDE REHAB SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE ERUBEL RIOS OT (OWNER/ADMINISTRATOR)
(956) 821-3646
Entity
Organization
Contact information
Practice address
1921 S 34TH ST, MCALLEN, TX 78503-8323
(956) 821-3646
Mailing address
1921 S 34TH ST, MCALLEN, TX 78503-8323
(956) 821-3646
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207861006
—
TX
05
—
207861007
—
TX
Enumeration date
09/10/2018
Last updated
02/01/2020
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