| NPI | 1528693850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH KLEINBECK Director 501-747-1731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-09-25 |