| NPI | 1972063634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE LASCALLA CEO 424-269-3400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251N0400X Physical Therapist Neurology | |
| 2251P0200X Physical Therapist Pediatrics | |
| 2251X0800X Physical Therapist Orthopedic | |
| 225X00000X Occupational Therapist | |
| 225XF0002X Occupational Therapist Feeding, Eating & Swallowing | |
| 225XN1300X Occupational Therapist Neurorehabilitation | |
| 225XP0019X Occupational Therapist Physical Rehabilitation | |
| 225XP0200X Occupational Therapist Pediatrics | |
| 235Z00000X Speech-Language Pathologist | |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2021-07-22 |