| NPI | 1043040413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS V WALEKR Owner 262-504-0241 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 133NN1002X Nutritionist Nutrition, Education | |
| 163WH1000X Registered Nurse Hospice | |
| 2278E0002X Respiratory Therapist, Certified Emergency Care | |
| 251E00000X Home Health | |
| 251T00000X Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 261QG0250X Clinic/Center Genetics | |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 385H00000X Respite Care | |
| 385HR2050X Respite Care Respite Care Camp | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2024-09-13 |