{"npi":"1588978613","type":"NPI-2","status":"active","name":{"display":"Innovative Rehabilitation, LLC","other":[],"organization_name":"INNOVATIVE REHABILITATION,LLC","authorised_official":"Amy Crow"},"specialty":{"primary_taxonomy":"261QR0400X","primary_taxonomy_description":"Rehabilitation Clinic/Center","slug":"rehabilitation-clinic-center","schema_org_specialty":null,"all":[{"code":"235Z00000X","description":"Speech-Language Pathology","primary":false,"state":"TX","license":"107336"},{"code":"225X00000X","description":"Occupational Therapist","primary":false,"state":"TX","license":"111675"},{"code":"261QP2000X","description":"Physical Therapy Clinic/Center","primary":false,"state":null,"license":null},{"code":"2355S0801X","description":"Speech-Language Assistant","primary":false,"state":null,"license":null},{"code":"235Z00000X","description":"Speech-Language Pathology","primary":false,"state":"TX","license":"24933"},{"code":"235Z00000X","description":"Speech-Language Pathology","primary":false,"state":"TX","license":"15485"},{"code":"224Z00000X","description":"Occupational Therapy Assistant","primary":false,"state":null,"license":null},{"code":"225200000X","description":"Physical Therapy Assistant","primary":false,"state":null,"license":null},{"code":"225X00000X","description":"Occupational Therapist","primary":false,"state":"TX","license":"109182"},{"code":"261QR0400X","description":"Rehabilitation Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"440 HIGHWAY 59 LOOP S STE 104","city":"LIVINGSTON","state":"TX","postal_code":"773519011","country_code":"US","phone":"9363288148","fax":"9363272491"},{"purpose":"MAILING","street_1":"440 HIGHWAY 59 LOOP S STE 104","city":"LIVINGSTON","state":"TX","postal_code":"773519011","country_code":"US","phone":"9363288148","fax":"9363272491"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1588978613","state":"TX","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20130628000591","type_code":"00-14","type_desc":"PART A PROVIDER - OUTPATIENT PHYSICAL THERAPY/OCCUPATIONAL THERAPY/SPEECH PATHOLOGY SERVICES","state":"TX","pac_id":"1658511431"}]},"enumeration_date":"2010-07-30","last_updated":"2025-01-24","_meta":{"source":"NPPES","snapshot_date":"2025-01-24","doc_url":"https://findmynpi.com/api"}}