| NPI | 1730651969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK M BEVELL Director 928-826-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |