| NPI | 1164024113 |
|---|---|
| Doing Business As | JASMINE RANDLE-MAYES |
| Entity Type | Organization |
| Authorized Contact | JASMINE RANDLE-MAYES Occupational Therapist 815-557-2728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2020-11-13 |