| NPI | 1144595596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD EDWARD MCRAE Owner/Administrator 706-504-2380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: SC 17665) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: GA LCB20120000162) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |