| NPI | 1760189583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY G COUCH Owner 937-824-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-08-03 |