| NPI | 1164951141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARAK CHARARA Owner 313-400-0063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2017-06-05 |