| NPI | 1962551648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE LEE NEWTON Executive Director 888-880-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2022-06-21 |