Organization
LITTLE LIGHTHOUSE CHILDRENS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK LEE PEREZ (ASSITANT ADMINISTRATOR)
(956) 943-9600
Entity
Organization
Contact information
Practice address
503 W OCEAN BLVD STE B, LOS FRESNOS, TX 78566-3620
(956) 233-4111
(956) 233-4115
Mailing address
503 W OCEAN BLVD STE B, LOS FRESNOS, TX 78566-3620
(956) 233-4111
(956) 233-4115
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174327001
—
TX
Enumeration date
10/11/2006
Last updated
04/25/2012
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