NPI | 1023508595 |
---|---|
Entity Type | Organization |
Authorized Contact | SAMAIYAH HARRIS Owner 904-414-1785 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Additional Taxonomies | 385H00000X Respite Care |
385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
251E00000X Home Health | |
253Z00000X In Home Supportive Care | |
343900000X Non-emergency Medical Transport (VAN) | |
347C00000X Private Vehicle | |
Enumeration Date | 2018-05-10 |
Last Update Date | 2020-11-06 |