NPI | 1053743856 |
---|---|
Doing Business As | MOODY NEUROREHABILITATION INSTITUTE - TIDEWAY |
Doing Business As | TIDEWAY |
Entity Type | Organization |
Authorized Contact | JAMES ANDERSON Contract Manager 409-797-1468 |
Organization Subpart ? | No |
Primary Taxonomy | 310400000X Assisted Living Facility (Licence: TX 134987) |
Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
Enumeration Date | 2013-08-02 |
Last Update Date | 2019-12-09 |