| NPI | 1215544390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME ALLEN Owner 832-930-2970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2020-09-24 |