Provider Demographics
NPI:1487458709
Name:ELEVIVE REHABILITATION LLC
Entity type:Organization
Organization Name:ELEVIVE REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REHABILITATION
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:REAMICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-847-7025
Mailing Address - Street 1:17350 STATE HIGHWAY 249 STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1132
Mailing Address - Country:US
Mailing Address - Phone:346-847-7025
Mailing Address - Fax:
Practice Address - Street 1:1110 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3378
Practice Address - Country:US
Practice Address - Phone:346-847-7025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty