| NPI | 1659036846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA STREETER Chief Administrative Officer 800-699-9395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2025-08-27 |