| NPI | 1104827963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN WILLIAM KOLNACKI Administrator 520-648-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: AZ NCI402) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2014-02-14 |