| NPI | 1912289935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE MARROTT Administrator 915-598-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: TX 106791) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |