Organization
STATE COMMUNITY REHAB AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN MICKENS (COORDINATOR)
(713) 662-0502
Entity
Organization
Contact information
Practice address
11205 MAIN ST STE 118, HOUSTON, TX 77025-5602
(713) 662-0501
Mailing address
11205 MAIN ST STE 118, HOUSTON, TX 77025-5602
(713) 662-0501
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
09/22/2006
Last updated
08/22/2020
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