| NPI | 1932386448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBERLY C MASON Owner 251-425-2170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: AL PTH4377) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-06-12 |