| NPI | 1063384873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARAYSHA LYLES Manager 224-419-9352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 283XC2000X Rehabilitation Hospital, Children | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2025-09-22 |
| Last Update Date | 2025-09-22 |