NPI | 1528144318 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTINA MICHELLE DUNCAN Credentialing Specialist 479-967-2322 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
Enumeration Date | 2006-10-27 |
Last Update Date | 2022-12-28 |