| NPI | 1053197798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL ALLAN BURNS AO 330-503-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2023-09-13 |