| NPI | 1306413315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN SERFASS Regional Director 667-600-2118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-06-08 |