| NPI | 1932094968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL CUESTA Owner 800-962-4961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-10 |