| NPI | 1194024588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGHANNE P PAIGE Owner 731-599-9896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit (Licence: TN 2010-16555) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2014-06-24 |