| NPI | 1053154765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY GOGIN Owner 920-840-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-22 |