| NPI | 1013893130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIERA WILSON Owner 757-769-9486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-10-23 |