| NPI | 1134411671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Mgr Provider Enrollment 502-630-7425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 171W00000X Contractor |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2024-05-13 |