| NPI | 1114403185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASZLOYN NIKITA WAKEFIELD CEO 904-622-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-17 |