Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
261QR0401X | B4[14] | Comprehensive Outpatient Rehabilitation Facility |
| NPI # | 1730630203 |
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| LBN Legal business name | CLINICAL CONSULTANTS LLC | ||||
| Authorized official | MIKE ODOM - (PROGRAM ADMINISTRATOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 10/20/2016 | ||||
| Last updated | 10/20/2016 - About 10 years ago | ||||
| Identifiers |
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