| NPI | 1023769254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE D JOHNSON Owner 407-504-0189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-01-10 |