| NPI | 1043393507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Mgr Provider Enrollment 502-630-7425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2022-08-02 |