| NPI | 1053068502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT YATES Contract Manager 877-262-7803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 171R00000X Interpreter |
| 251E00000X Home Health | |
| 251X00000X Supports Brokerage | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2024-10-01 |