NPI | 1457912289 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES MAIZE Cco 641-472-1684 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Enumeration Date | 2019-06-24 |
Last Update Date | 2021-10-18 |