| NPI | 1093018830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNTINA MOORE Administrator 877-232-7242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: IL 056.008266) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2012-06-25 |