| NPI | 1073944245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDIE HOLMES Owner 888-570-5538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: FL 10740) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2017-04-08 |