| NPI | 1649663931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNIQUE STOKES President 386-212-5088 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation Brain Injury Medicine |
| 225XN1300X Occupational Therapist Neurorehabilitation | |
| 251J00000X Nursing Care | |
| 261Q00000X Clinic/Center | |
| 261QR0400X Clinic/Center Rehabilitation | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2020-04-13 |