| NPI | 1083406359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY TIERRA JACKSON Owner 980-257-2795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251E00000X Home Health |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 175T00000X Peer Specialist | |
| 174200000X Meals | |
| 251B00000X Case Management | |
| Enumeration Date | 2025-05-21 |
| Last Update Date | 2025-12-01 |