| NPI | 1083152854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA HUBBARD Director/ Lpn 267-408-6417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN084112L) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |