| NPI | 1154130235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDRISSA LO Owner 813-774-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2025-01-03 |
| Last Update Date | 2025-01-03 |