| NPI | 1083293542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCOISE WAMBO FOMUNUNG Owner 469-655-0038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 3747A0650X Technician Attendant Care Provider | |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2021-04-03 |