| NPI | 1104272970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIJUANA SHEREE IRVING Owner 352-575-7963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| 253J00000X Foster Care Agency | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |