| NPI | 1104416114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEYINKA WINDAPO CEO 443-251-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2021-06-15 |