Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Clinic/Center |
261Q00000X | |||
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
261QR0401X | B4[14] | Comprehensive Outpatient Rehabilitation Facility |
| NPI # | 1568772655 |
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| LBN Legal business name | LAYNE STOOPS | ||||||||
| Authorized official | LAYNE STOOPS - (OWNER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 10/07/2010 | ||||||||
| Last updated | 10/07/2010 - About 16 years ago | ||||||||
| Identifiers |
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