| NPI | 1669285524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BISHAR A YUSUF Owner 612-703-9413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-01-27 |