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Intangible Assets, net (Details) $ in Thousands | 12 Months Ended |
--- | --- | ---
Dec. 31, 2018 USD ($) | Dec. 31, 2016 Operation | Dec. 31, 2017 USD ($)
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Total | $ 48,828 |  | $ 48,954
Number of acquired operations | Operation |  | 2 |
Tradenames [Member] |  |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Total | 30,256 |  | 29,673
Referral Relationships [Member] |  |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Total | 16,895 |  | 16,811
Accumulated amortization | $ 9,370 |  | 7,209
Referral Relationships [Member] | Minimum [Member] |  |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Estimated useful life | 6 years |  |
Referral Relationships [Member] | Maximum [Member] |  |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Estimated useful life | 16 years |  |
Non-compete Agreements [Member] |  |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Total | $ 1,677 |  | 2,470
Accumulated amortization | $ 4,716 |  | $ 4,100
Non-compete Agreements [Member] | Minimum [Member] |  |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Estimated useful life | 5 years |  |
Non-compete Agreements [Member] | Maximum [Member] |  |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |  |
Estimated useful life | 6 years |  |

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- Definition Useful life of finite-lived intangible assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days. + References No definition available. + Details
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- Definition Sum of the carrying amounts of all intangible assets, excluding goodwill, as of the balance sheet date, net of accumulated amortization and impairment charges. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 2 -Subparagraph ((a)(1),(b)) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 45 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6388964&loc=d3e16212-109274 + Details
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