| Organization Name: | BRC OUTPATIENT SERVICES, LLC |
| NPI Number: | 1366838005 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA JONES SWANN (CLINICAL DIRECTOR) |
| Mailing Address: | 11502 Parsons Rd Manor |
| State: | TX US |
| Postal Code: | 786535220 |
| Phone Number: | 5122784550 |
| Fax Number: | 5122784553 |
| NPI Enumeration Date: | 04/09/2015 |
| NPI Last Update Date: | 07/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0401X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Taxonomy Definition: | |