| NPI | 1518076629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETHA A HAYNES Owner 985-652-4136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-04-21 |