| NPI | 1144674698 |
|---|---|
| Other Name | MIND REHABILITATION & RESOURCE CENTER |
| Entity Type | Organization |
| Authorized Contact | LATOYTA DANIELLE MANDOSIA Mhs 318-828-1455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |