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Intangible Assets, net (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2017
USD ($)
Dec. 31, 2016
USD ($)
Operation
Finite-Lived Intangible Assets [Line Items]    
Total $ 48,954 $ 38,060
Number of acquired operations | Operation   2
Tradenames [Member]    
Finite-Lived Intangible Assets [Line Items]    
Total 29,673 $ 21,234
Referral Relationships [Member]    
Finite-Lived Intangible Assets [Line Items]    
Total 16,811 14,859
Accumulated amortization $ 7,209 5,275
Referral Relationships [Member] | Minimum [Member]    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life 6 years  
Referral Relationships [Member] | Maximum [Member]    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life 16 years  
Non-compete Agreements [Member]    
Finite-Lived Intangible Assets [Line Items]    
Total $ 2,470 1,967
Accumulated amortization $ 4,100 $ 3,380
Non-compete Agreements [Member] | Minimum [Member]    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life 5 years  
Non-compete Agreements [Member] | Maximum [Member]    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life 6 years