| NPI | 1063000453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TICHAWONA MICHELLE MARANYIKA Ce0/Administrator 469-647-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 385H00000X Respite Care | |
| Enumeration Date | 2021-01-02 |
| Last Update Date | 2021-01-02 |