| NPI | 1720451453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY RASMUSSEN-JONES Secretary 479-201-4835 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2022-03-10 |