| NPI | 1861671935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN BANADOS ANDRADA President 478-405-7010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: GA 4707) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2013-01-10 |