| NPI | 1760753545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE LITTLE HYLTON Owner 276-780-3374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: VA 2202006031) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225200000X Physical Therapy Assistant | |
| 252Y00000X Early Intervention Provider Agency (Licence: VA 0119003180) | |
| 252Y00000X Early Intervention Provider Agency (Licence: VA 2202006031) | |
| 261QR0400X Clinic/Center, Rehabilitation (Licence: VA 0119003180) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2025-09-02 |