NPI | 1902075807 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACIE ANN GONNER CEO 870-338-8447 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Enumeration Date | 2008-02-25 |
Last Update Date | 2008-02-25 |