| NPI | 1790996304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA AGATHA SHEPPARD President 619-398-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: CA B20030226685) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2014-06-20 |