| NPI | 1366100760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANI WILSON President 443-468-1816 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2022-04-05 |