| NPI | 1699777987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BANASZAK Executive Director 269-963-5934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2011-03-22 |