| NPI | 1174354476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MCKENZIE CORY PARADISE Owner 661-472-1676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 253Z00000X In Home Supportive Care | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 3747P1801X Technician Personal Care Attendant | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-13 |