Provider Demographics
NPI:1619730694
Name:MIGHTY KIDS REHABILITATION LLC
Entity type:Organization
Organization Name:MIGHTY KIDS REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:EME
Authorized Official - Middle Name:
Authorized Official - Last Name:BLESSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-306-1234
Mailing Address - Street 1:5517 N MCCOLL RD # 3
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2208
Mailing Address - Country:US
Mailing Address - Phone:956-306-1234
Mailing Address - Fax:956-707-4343
Practice Address - Street 1:5517 N MCCOLL RD # 3
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2208
Practice Address - Country:US
Practice Address - Phone:956-306-1234
Practice Address - Fax:956-707-4343
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WYNSTON HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty