| NPI | 1265832224 |
|---|---|
| Doing Business As | POWERBACK REBAHILITATION LAFAYETTE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL T BERG Assistant Secretary 505-468-4742 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CO 0000) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: CO 00000) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2015-10-29 |