| NPI | 1841610847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN ROLAND BLAKE President/Owner 619-829-6961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: CA PT38074) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |