| NPI | 1891885927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRE VANDENBENT Authorized Official 214-514-1897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2026-01-16 |