| NPI | 1962054858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY D GOLD Owner 210-724-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2025-07-10 |