| NPI | 1144748922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTANA JOHNSON President/Owner 321-430-8194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health (Licence: FL 234841) |
| 347C00000X Private Vehicle | |
| 376J00000X Homemaker | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2021-08-17 |