Provider Demographics
NPI:1174565691
Name:SUPERKIDS REHABILITATION, INC.
Entity type:Organization
Organization Name:SUPERKIDS REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:956-831-7600
Mailing Address - Street 1:5337 S PADRE ISLAND HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-4409
Mailing Address - Country:US
Mailing Address - Phone:956-831-7600
Mailing Address - Fax:956-831-0386
Practice Address - Street 1:5337 S PADRE ISLAND HWY
Practice Address - Street 2:SUITE B
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-4409
Practice Address - Country:US
Practice Address - Phone:956-831-7600
Practice Address - Fax:956-831-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty