| NPI | 1003865452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL DE AVILA Administrator 915-778-1796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |