| NPI | 1104462985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YONA K ASSAH Administrator 267-368-2950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| 251E00000X Home Health | |
| 310400000X Assisted Living Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 372600000X Adult Companion | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2019-11-28 |