| NPI | 1588298814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEXTER SIMMONS Owner 409-466-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-03-17 |