| NPI | 1891949707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANI S. BACON Co Founder & Physical Therapist 704-807-5699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QA3000X Clinic/Center, Augmentative Communication | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 251E00000X Home Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2015-08-20 |