| NPI | 1215697297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB MEDFORD Owner/ CEO 619-708-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2021-12-18 |
| Last Update Date | 2021-12-18 |