| NPI | 1104542117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH UWAGBAI Owner 682-554-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-12 |