| NPI | 1487169843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINCOLN WAYNE DAVIS Registered Agent 361-727-6141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2018-01-31 |