| NPI | 1124836788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA NALLS Administrator 937-623-2377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Additional Taxonomies | 251E00000X Home Health |
| 251F00000X Home Infusion | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2024-12-27 |
| Last Update Date | 2024-12-31 |