| NPI | 1316295827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MILLER Director 254-733-0167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |