Provider Demographics
NPI:1447533146
Name:BELTWAY DIAGNOSTIC AND REHAB CENTER
Entity type:Organization
Organization Name:BELTWAY DIAGNOSTIC AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:PENAFLOR
Authorized Official - Last Name:OHUONU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-780-1181
Mailing Address - Street 1:9889 BELLAIRE BLVD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3463
Mailing Address - Country:US
Mailing Address - Phone:281-780-1181
Mailing Address - Fax:713-995-1002
Practice Address - Street 1:9889 BELLAIRE BLVD
Practice Address - Street 2:SUITE 134
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3463
Practice Address - Country:US
Practice Address - Phone:281-780-1181
Practice Address - Fax:713-995-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF009617320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities