| NPI | 1871963561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON W. SUTTON Member 719-640-3786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-11-18 |