| NPI | 1053180471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Mgr Provider Enrollment 502-630-7425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2024-11-18 |