| NPI | 1285884130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUANTRELL L. WASHINGTON Co Owner 210-363-7759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2012-02-24 |