| NPI | 1295466670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOSEPH RICHE Authorized Official 601-209-7697 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2022-06-17 |