| NPI | 1518060060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH DIANE DURHAM Administrator 459-831-2541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2024-02-26 |