| NPI | 1962489310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER F CROWDER CEO 409-935-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: TX 617670000) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: TX 520220000) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2012-02-13 |