| NPI | 1912645391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE MCCOLLUM Delegated Official 734-837-1048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-05-25 |