| NPI | 1124867825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEHNESHA MITCHELL Owner/Administrator 704-734-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 291U00000X Clinical Medical Laboratory | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-05-22 |