| NPI | 1609268952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN JOHNSON Manager 410-583-2665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: MD 06208) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |